糖尿病合并白内障及单纯老年性白内障与房水中细胞因子相关性的临床研究

目的探讨糖尿病合并白内障及单纯老年性白内障与房水中细胞因子的相关性。 方法收集2017年10月至2018年2月在内蒙古医科大学附属医院接受白内障手术治疗49例患者(49只眼)的临床资料。其中,男性22例(22只眼),女性27例(27只眼),平均年龄(64.4±9.7)岁。依据患者是否患有糖尿病,分为实验1组和实验2组。其中,糖尿病合并白内障患者14例(14只眼)为实验1组;单纯老年性白内障患者35例(35只眼)为实验2组。所有患者白内障术中收集房水。采用细胞因子微球技术检测患者血清及房水中白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、血管内皮生长因子(VEGF)、血管细胞粘附分子-1(VCAM-1)及成纤维细胞生长因子(bFGF)的浓度,酶联免疫吸附试验检测人血管内皮细胞生长因子B(VEGF-B)和胎盘生长因子(PLGF)的浓度。采用Spearman相关分析评价两组房水中各细胞因子浓度与晶状体皮质混浊、核性混浊及后囊下混浊的相关性。 结果实验1组和2组患者房水中IL-8、IL-10、VEGF、BFGF、VCAM-1、PLGF、VEGF-B浓度分别为(31.69±27)pg/ml、(5.2±0.41)pg/ml、(47.27±20.58)pg/ml、(17.28±4.11)pg/ml、(416.5±310.66)pg/ml、(17.85±6.70)pg/ml、(65.54±26.89)pg/ml、(12.38±6.52)pg/ml、(3.7±2.13)pg/ml、(36.54±14.97)pg/ml、(17.43±4.33)pg/ml、(331.39±205.80)pg/ml、(22.21±17.47)pg/ml及(74.36±26.75)pg/ml。实验1组房水中VCAM-1浓度与晶状体核性混浊呈负相关(r＝-0.61,P<0.05)。实验1组和2组患者血清中各细胞因子与晶状体核性混浊无相关性(r＝-0.03,-0.10,0.26,0.04,-0.32,-0.19;P均>0.05)、(r＝-0.15,0.13,-0.15,-0.11,0.11,-0.18;P均>0.05)、(r＝0.21,0.53,0.20,0.13,-0.12,0.16;P均>0.05)、(r＝-0.06,0.03,-0.01,-0.20,0.09,0.20;P均>0.05)、(r＝0.39,0.02,-0.11,-0.20,-0.13,0.03;P均>0.05)及(r＝0.13,0.09,0.32,0.25,0.11,-0.10;P均>0.05)。 结论两组房水中细胞因子与白内障之间规律不同。糖尿病患者房水中VCAM-1的浓度与晶状体的核性混浊呈负相关,VCAM-1可能是核性白内障的保护性因素。

The relationship between cytokine level in aqueous humor and diabetes mellitus with cataract and age-related cataract

ObjectiveThis study was aim to investigate the changes of factors in aqueous humor of diabetes mellitus with cataract, and to analyze their relationship with cataract of diabetic patients. MethodsClinical data of 49 patients (49 eyes) receiving cataract surgery in the affiliated hospital of Inner Mongolia Medical University from October 2017 to February 2018 were collected, including 14 patients (14 eyes) with diabetes mellitus with cataract as the experimental group and 35 patients (35 eyes) with simple senile cataract as the cataract group. Among of the experimental group, the age was 54 to 75, the average age was (64.8±10.7). Among of the cataract group, the age was 55 to 72, the average age was (64.0±8.8). All the patients conduct preoperative collection of fasting venous blood and intraoperative collection of aqueous humor. Using cytometric bead array to detect vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), interleukin-8 (IL-8), interleukin-10 (IL-10) and vascular cell adhesion molecule-1 (VCAM-1) and using enzyme-linked immuno-sorbent assay to detect vascular endothelial growth factor B (VEGF-B) and placental growth factor (PLGF). Spearman′s rank correlation coefficient was used to detect the correlation aqueous humour levels of IL-8, IL-10, VEGF, bFGF, PLGF, VCAM-1 and VEGF-B with cortical opacity, nuclear opacity and posterior subcapsular opacity in both groups. Spearman′s rank correlation coefficient was also used to detect the correlation serum levels of IL-8, IL-10, VEGF, bFGF, VCAM-1 and VEGF-B with cortical opacity, nuclear opacity and posterior subcapsular opacity between two groups. ResultsThe aqueous humor concentrations of IL-8, IL-10, VEGF, BFGF, VCAM-1, PLGF and VEGF-B in the experimental 1 and 2 group were (31.69±27)pg/ml, (5.2±0.41) pg/ml, (47.27±20.58) pg/ml, (17.28±4.11) pg/ml, (416.5±310.66) pg/ml, (17.85±6.70) pg/ml, (65.54±26.89) pg/ml, (12.38±6.52) pg/ml, (3.7±2.13) pg/ml, (36.54±14.97) pg/ml, (17.43±4.33) pg/ml, (331.39±205.80) pg/ml, (22.21±17.47) pg/ml, (74.36±26.75) pg/ml, respectively. The concentration of VCAM-1 in aqueous humor was negatively correlated with nuclear opacity in the experimental 1 group (r=-0.61, P<0.05). The concentration of all factors in serum was not correlated with nuclear opacity in the experimental 2 group (r=-0.03, -0.10, 0.26, 0.04, -0.32, -0.19; P>0.05), (r=-0.15, 0.13, -0.15, -0.11, 0.11, -0.18; P>0.05), (r=0.21, 0.53, 0.20, 0.13, -0.12, 0.16; P>0.05), (r=-0.06, 0.03, -0.01, -0.20, 0.09, 0.20; P>0.05), (r=0.39, 0.02, -0.11, -0.20, -0.13, 0.03; P>0.05) and (r=0.13, 0.09, 0.32, 0.25, 0.11, -0.10; P>0.05). ConclusionThe concentration of VCAM-1 in aqueous humor of diabetic patients was negatively correlated with the nuclear opacity, and VCAM-1 may act as a protective factor for nuclear cataract.