CAJ | 학술논문

目的通过测定并比较视网膜脱离患者行玻璃体切除联合硅油填充术后继发青光眼患者房水中的TNF-α的含量,并探讨其在硅油眼继发青光眼中的发病机制,从而为临床治疗提供切人点.方法选取因孔源性视网膜脱离行玻璃体切除联合硅油填充术后继发青光眼及术后无眼压升高、行硅油取出或联合小梁切除术的患者作为研究对象.同时选取单纯白内障患者作为对照.所有病例行手术时抽取未稀释的房水约0.1～0.2 ml,-70℃深低温冰箱冻存备用.用放射免疫法测定房水标本中的TNF-α的含量.用SAS V8软件进行统计学分析.结果第Ⅰ组14例,房水中TNF-α含量平均(1.0404±0.2449) ng/ml,第Ⅱ组16例,房水中TNF-α含量平均(0.6894±0.3152) ng/ml,第Ⅲ组17例,房水中TNF-α含量平均(0.7099±0.1992) ng/ml.经统计学分析,房水标本中的TNF-α含量各组间差异有统计学意义,(F =8.65,P=0.0007,P＜0.05),第Ⅰ组与第Ⅱ组、第Ⅲ组间差异显著,有统计学意义,而后两组间差异不显著,无统计学意义.结论房水标本中TNF-α的含量在视网膜脱离行玻璃体切除联合硅油填充术后继发青光眼的患眼中明显升高,TNF-α可能是硅油眼继发青光眼发病机制的一个重要的细胞因子.
목적 통과측정병비교시망막탈리환자행파리체절제연합규유전충술후계발청광안환자방수중적TNF-α적함량,병탐토기재규유안계발청광안중적발병궤제,종이위림상치료제공절인점.방법 선취인공원성시망막탈리행파리체절제연합규유전충술후계발청광안급술후무안압승고、행규유취출혹연합소량절제술적환자작위연구대상.동시선취단순백내장환자작위대조.소유병례행수술시추취미희석적방수약0.1～0.2 ml,-70℃심저온빙상동존비용.용방사면역법측정방수표본중적TNF-α적함량.용SAS V8연건진행통계학분석.결과 제Ⅰ조14례,방수중TNF-α함량평균(1.0404±0.2449) ng/ml,제Ⅱ조16례,방수중TNF-α함량평균(0.6894±0.3152) ng/ml,제Ⅲ조17례,방수중TNF-α함량평균(0.7099±0.1992) ng/ml.경통계학분석,방수표본중적TNF-α함량각조간차이유통계학의의,(F =8.65,P=0.0007,P＜0.05),제Ⅰ조여제Ⅱ조、제Ⅲ조간차이현저,유통계학의의,이후량조간차이불현저,무통계학의의.결론 방수표본중TNF-α적함량재시망막탈리행파리체절제연합규유전충술후계발청광안적환안중명현승고,TNF-α가능시규유안계발청광안발병궤제적일개중요적세포인자.
Objective To determine and compare the concentration of TNF-α in aqueous humor of secondary glaucoma after vitrectomy and silicon oil intraocular injection in patients with rhegmatogenous retinal detachment,and to explore its pathogenesis in the silicon oil glaucoma,and hope to provide an entry point for clinical treatment. Method The patients whose intraocular pressure (IOP) and the fundus were in a stable condition after vitrectomy and silicon oil intraocular injection in patients with rhegmatogenous retinal detachment,postoperative secondary glaucoma with normal range IOP,received the operation of silicon oil removal or trabeculectomy at the same time were chosen as study group.Meanwhile,the patients who had cataract in the corresponding period were chosen as the control group.About 0.1-0.2ml aqueous humor was obtained from all the patients,stored in the -70℃ cryogenic refrigerator for spare use.The contents of TNF-α in the samples were measured by radioimmunoassay.All the data obtained from the experiment were analyzed by SAS V8 software. Results In group Ⅰ,TNF-α was detected in 14 cases and its average content was 1.0404±0.2449ng/ml; in group Ⅱ,TNF-α was detected in 16 cases and its average content was 0.6894±0.3152ng/ml; in group Ⅲ,TNF-α was detected in 17 cases and its average content was 0.7099±0.1992 ng/ml.Through statistical analysis,the differences in the contents of TNF-α in the aqueous humor samples of each group were obvious and had statistical significance (F =8.65,P =0.0007,P ＜0.05).There were obvious differences between the group Ⅰ and the other two groups with statistical significance.However,the group Ⅱ and the group Ⅲ had no obvious differences,had no statistical significance. Conclusions The content of the TNF-α in the patients of secondary glaucoma after vitrectomy and silicon oil injection in patients with rhegmatogenous retinal detachment is obviously higher,hence,TNF-α may be a significant factor in the pathogenesis of the silicon oil glaucoma..