长期联合应用噻吗洛尔对结膜组织炎性标记物ICAM-1和HLA-DR表达的影响

目的通过观察长期应用噻码洛尔后炎性标记物细胞间黏附分子-1(intercellular adhesion molecule-1,ICAM-1)和人类白细胞抗原-DR(human leukocyte antigen-DR,HLA-DR)在结膜组织中的表达,探讨长期应用抗青光眼滴眼液对结膜炎症反应的影响。方法原发性开角型青光眼患者90例,根据抗青光眼药物治疗的种类分为3组:应用2种青光眼药物治疗(5g·L-1噻吗洛尔与2g·L-1阿法根)即联合用药组30例,1种抗青光眼药物治疗(5g·L-1噻吗洛尔)即单一用药组30例,无抗青光眼药物治疗即未用药组30例。另选择单纯白内障患者30例作为空白对照组。按抗青光眼药物治疗时间及白内障患病时间分为3个时相(0～6个月、7～12个月、13～18个月)组,每组10例。应用免疫组织化学染色检测结膜组织中ICAM-1和HLA-DR的表达。结果单一用药组与联合用药组在13～18个月时结膜组织中ICAM-1阳性细胞数分别是22.59±1.85和32.61±1.53,与空白对照组(5.12±1.14)相比差异均有统计学意义(均为P<0.01);联合用药组与单一用药组在13～18个月时结膜组织中ICAM-1阳性细胞数较0～6个月(6.27±1.39、6.21±1.45)、7～12个月(7.07±1.32、6.89±1.31)明显增多,差异均有显著统计学意义(均为P<0.01)。HLA-DR的表达同ICAM-1表达结果一致。结论长期联合应用抗青光眼药物可致结膜组织发生炎性反应,结膜组织中ICAM-1和HLA-DR表达明显增加。

Effect of long-term combined treatment with timolol on conjunctiva inflammatory marker ICAM-1 and HLA-DR expression

Objective To observe the expression of conjunctival inflammatory marker intercellular adhesion molecule-1(ICAM-1) and human leukocyte antigen-DR(HLA-DR) after long-term treatment with timolol,and investigate the effect of long-term treatment with anti-glaucoma eye drops on conjunctival inflammation.Methods Ninety primary open-angle glaucoma patients were divided into three groups in accordance with the treatment type of anti-glaucoma drug:Combined treatment group(5 g·L-1 timolol and 2 g·L-1 alphagan,30 cases),single treatment group(5 g·L-1 timolol,30 cases),non-drug treatment group(30 cases).Another 30 patients with simple cataract were set as control group.All patients in each group were divided into 3 time phrase sub-group(0-6 months,7-12 months and 13-18 months) by anti-glaucoma drug treatment time and cataract during,10 cases in each sub-group.ICAM-1and HLA-DR expression in conjunctival tissue were detected by immunohistochemical method.Results At the 13-18 months time point,the number of ICAM-1 positive cells in conjunctival tissue in single treatment group and combined treatment group were 22.59±1.85,32.61±1.53,respectively,compared with that in control group(5.12±1.14),there were significant differences(both P<0.01).The number of ICAM-1 positive cells in conjunctival tissue in combined treatment group and single treatment group at 13-18 months time point were obviously more than that at 0-6 months time point(6.27±1.39,6.21±1.45) and 7-12 months(7.07±1.32,6.89±1.31),there were significant differences(all P<0.01).HLA-DR expression was the same as ICAM-1.Conclusion Long-term combined treatment with anti-glaucoma can lead to conjunctival inflammation,ICAM-1 and HLA-DR expression in conjunctival tissue increase significantly.