摘要
目的研究房水细胞因子表达水平在中青年与老年视网膜静脉阻塞继发黄斑水肿(RVO-ME)患者玻璃体腔注射抗血管内皮生长因子(VEGF)治疗前后的差异,探讨房水细胞因子水平对预测不同年龄RVO-ME患者疗效的意义。方法选取2022年1月至2024年6月于南昌市第一医院确诊为RVO-ME的患者42例(42眼),分为中青年组(发病年龄≤50岁)14例(14眼)和老年组(发病年龄>50岁)28例(28眼)。两组均进行玻璃体腔注射雷珠单抗(IVR)治疗,分析两组治疗效果,治疗前后房水细胞因子VEGF、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)表达水平的差异及基线前房水细胞因子表达水平与黄斑中心凹厚度(CMT)的相关性分析。结果RVO-ME患者抗VEGF治疗后,最佳矫正视力(BCVA)提高、CMT显著减少(P<0.05);老年组较中青年组改善明显,差异有统计学意义(P<0.05)。治疗前,中青年组与老年组房水细胞因子中VEGF表达水平差异无统计学意义(P>0.05);IL-6、IL-8表达水平中青年组明显高于老年组(P<0.05);治疗后,两组患者房水细胞因子VEGF表达水平较治疗前明显下降,差异有统计学意义(P<0.05),老年组患者下降较中青年组更为明显,差异有统计学意义(P<0.05);治疗后,两组患者IL-6和IL-8表达水平均低于治疗前,两组患者治疗前后IL-6和IL-8变化值差异无统计学意义(P>0.05);基线房水细胞因子VEGF和IL-8表达水平与CMT存在显著正相关性(P<0.05)。结论中青年和老年RVO-ME患者ME及缺血程度差异无统计学意义(P>0.05),但中青年患者的炎症因素更明显。抗VEGF药物可显著降低RVO-ME患者房水细胞因子VEGF的表达水平,但对IL-6、IL-8表达水平无显著影响。短期内老年RVO-ME患者的治疗效果优于中青年患者,中青年患者进行抗VEGF治疗的同时,联合采用抗炎治疗可能更为关键。
Objective To study the expression level of aqueous humor cytokines in young and middle-aged patients with reti-nal vein occlusion secondary macular edema(RVO-ME)before and after antiVEGF treatment,and to explore the significance of aqueous humor cytokines in predicting the treatment effect of RVO-ME patients at different ages.Methods 42 patients(42 eyes)with RVO-ME diagnosed in the First Hospital of Nanchang from January 2022 to June 2024 were selected and divided into young and middle-aged group(onset age≤50 years)with 14 cases(14 eyes)and elderly group(onset age>50 years)with 28 cases(28 eyes).Both groups were treated with intravitreal ranibizumab(IVR),and the effect of antiVEGF treatment in patients with RVO-ME was analyzed The differences of IL-6 and IL-8 expression levels,and the correlation between baseline aqueous humor cy-tokine expression levels and CMT were analyzed.Results After anti VEGF treatment,BCVA increased and CMT decreased signif-icantly in RVO-ME patients(P<0.05);The elderly group improved significantly compared with the young and middle-aged group,and the difference was statisticallysignificant(P<0.05).There was no significant difference in the expression of VEGF in aque-ous humor cytokine between young and middle-aged patients and elderly patients before treatment(P>0.05);The expression levels of interleukin(IL)IL-6 and IL-8 in aqueous humor cytokine of young and middle-aged patients were significantly higher than those of elderly patients(P<0.05);After treatment,the expression levels of aqueous humor cytokine VEGF in the two groups were significantly decreased compared with those before treatment,and the differences were statistically significant(P<0.05).The decline in the elderly group was more obvious than that in the young and middle-aged group,and the differences were statistically sig nificant(P<0.05);The expression levels of aqueous humor cytokine IL-6and IL-8 in the two groups after treatment were lower than those before treatment,and there was no significant difference in the changes of IL-6 and IL-8 between the two groups before and after treatment(P>0.05);The expression levels of VEGF and IL-8 in aqueous humor cytokine were significantly positively corre.lated with CMT(P<0.05).Conclusion There is no significant difference in the degree of macular edema and ischemia between young and middle-aged patients and elderly patients with RVO-ME(P>0.05),but the inflammatory factors in young and middle-aged patients are more obvious.VEGF drugs can significantly reduce the expression of VEGF in aqueous humor cytokine of RVO-ME patients,but it has no significant effect on the expression of IL-6and IL.-8.In the short term,the treatment effect of elderly patients with RVO-ME is better than that of young and middle-aged patients.The combination of anti VEGF and anti-inflamma-tory therapy may be more critical for young and middle-aged patients.
作者
刘淼
金昱
徐月圆
元芳秀
LIU Miao;JIN Yu;XU Yueyuan;YUAN Fangxiu(Department of Ophthalmology,The First Hospital of Nanchang,Jiangxi,Nanchang,330008,China)
出处
《江西医药》
2025年第5期405-409,413,共6页
Jiangxi Medical Journal
基金
江西省卫生健康委普通科技计划项目,编号202211613。
关键词
中青年
老年
视网膜静脉阻塞
黄斑水肿
房水细胞因子
Middle-aged and young people
Old people
Retinal vein occlusion
Macular edema
Aqueous humor cytokines
