特发性黄斑前膜合并白内障患者房水中细胞因子表达及其与白内障手术预后的相关性研究

目的　探究特发性黄斑前膜（iERM）合并白内障患者房水中细胞因子的表达及其与白内障超声乳化手术预后指标的相关性。方法　选取2020年5月至2021年2月在南通大学附属医院眼科住院并行白内障超声乳化术的iERM患者（iERM组）25例（27眼）和老年性白内障患者（对照组）23例（25眼）为研究对象，分别收集两组患者的房水，运用Luminex液相芯片技术对房水中48种细胞因子水平进行测定。同时分析iERM组患者白内障超声乳化术术前和术后3个月相关指标，包括最佳矫正视力（BCVA）、黄斑中心凹厚度（CFT）、黄斑体积（MV）和黄斑平均厚度（MT）的变化与房水细胞因子之间的相关性。结果　iERM组患者房水样本中生长调节致癌基因-α（GRO-α）、白细胞介素 (IL)-2、IL-7和血小板源性生长因子-BB（PDGF-BB）的水平均显著高于对照组，差异均有统计学意义（均为P<0.001 5）。iERM组患者白内障超声乳化术术后视力明显改善，CFT、MV和MT均明显升高（均为P<0.05）。iERM组患者房水细胞因子CTACK浓度与BCVA（logMAR)变化（术后与术前的差值）呈正相关（r=0.445,P=0.043）；细胞因子IL-4浓度与MT变化（术后与术前差值）呈负相关（r=-0.471,P=0.031）。结论　对于iERM患者，房水中GRO-α、IL-2、IL-7和PDGF-BB可能参与了iERM的形成机制，CTACK可能与患者术后视力恢复缓慢有关，而IL-4则可能与患者术后黄斑厚度增加密切相关。

Research on the expression of cytokines in aqueous humor of cataract patients with idiopathic epiretinal membrane and its correlation with the prognosis after cataract surgery

Objective To investigate the expression of cytokines in aqueous humor(AH)of cataract patients with idiopathic epiretinal membrane(iERM)and its correlations with prognostic indicators after phacoemulsification.Methods Totally 25 iERM patients(27 eyes)and 23 senile cataract patients(25 eyes)who received phacoemulsification in the Affiliated Hospital of Nantong University from May 2020 to February 2021 were selected into the iERM group and control group,respectively.AH samples were collected from these two groups,and the Luminex suspension array technique was used to detect the levels of 48 cytokines in the samples.The best corrected visual acuity(BCVA),central foveal thickness(CFT),macular volume(MV),and macular thickness(MT)were recorded preoperatively and 3 months postoperatively,and their correlations with cytokines in AH were analyzed.Results The cytokine levels in growth regulated oncogene-α(GRO-α),interleukin(IL)-2,IL-7,and platelet derived growth factor-BB(PDGF-BB)were significantly higher in the iERM group than those in the control group,and the differences were statistically significant(all P<0.0015).Compared with preoperative conditions,iERM patients’BCVA improved significantly,and their CFT,MV and MT were also significantly increased after phacoemulsification(all P<0.05).In the iERM group,CTACK level was positively correlated with the BCVA(logMRA)changes(difference between postoperative and preoperative values)(r=0.445,P=0.043),and IL-4 level was negatively correlated with the MT changes(difference between postoperative and preoperative values)(r=-0.471,P=0.031).Conclusion AH cytokines GRO-α,IL-2,IL-7,and PDGF-BB may participate in the pathogenesis of iERM.CTACK may be related to the slow recovery of vision after surgery,and IL-4 may be associated with the increased MT postoperatively.