目的 观察和分析原发性青光眼合并2型糖尿病(T2DM)患者血液及房水中基质金属蛋白酶2(MMP-2)及金属蛋白酶2组织抑制因子(TIMP-2)的表达变化.方法 选取60例原发性青光眼患者,根据将合并T2DM情况将其分为A组(单纯POAG病例,15例23只眼)、B组(单纯PACG病例,15例26只眼)、C组(POAG合并T2DM病例,15例25只眼)、D组(PACG合并T2DM病例,15例23只眼),选取糖尿病性白内障病例(20例33只眼)作为E组,选取年龄相关性白内障病例(20例32只眼)作为F组.对6组患者房水及血清MMP-2、TIMP-2水平及比值进行观察和比较.结果 B组和D组患者的房水MMP-2、TIMP-2水平均高于其它各组,A组和C组患者的房水TIMP-2水平高于E组或F组,A组、B组、C组、D组患者的房水TIMP-2/MMP-2比值均显著高于E组或F组,差异均有统计学意义(P<0.05);A组患者的血清MMP-2、TIMP-2水平均高于其它各组,差异均有统计学意义(P<0.05),而6组患者血清TIMP-2/MMP-2比值的差异无统计学意义(F=1.634,P>0.05).结论 原发性青光眼患者血液和房水中存在着显著的MMP-2/TIMP-2系统失衡,但合并T2DM并不能加剧这一失衡状态,不具有促进青光眼进展的作用.%Objective To observe and analyze the expression of matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase-2 (TIMP-2) in blood and aqueous humor of patients with primary glaucoma complicated with type 2 diabetes mellitus (T2DM).Methods 60 primary glaucoma patients were selected and divided into Group A (simple POAG cases, n=23 eyes), Group B (simple PACG cases,n=26 eye), Group C (POAG complicated with T2DM,n=25 eyes), Group D (PACG complicated with T2DM, n=23 eyes).Patients with diabetic cataract (n=33 eyes) were selected as Group E and the patients with age-related cataract (n=32 eyes) were selected as Group F.Serum and aqueous MMP-2, TIMP-2 levels and their ratios in 6 groups were compared.Results Both aqueous MMP-2 and TIMP-2 levels were high in Group B and Group D (i.e., PACG patients with or without T2DM) than in other patients.Aqueous TIMP-2 level was high in Group A and Group C (i.e., POAG patients with or without T2DM) than in Group E or F.The TIMP-2/MMP-2 ratio was high in all glaucoma patients (Group A through D) than in non-glaucoma patients (Group E and F).Serum MMP-2 and TIMP levels were high in Group A than in all other groups (P<0.05).There was no significant difference in serum TIMP-2/MMP-2 ratio between the 6 groups (F=1.634,P>0.05).Conclusions There was significant imbalance in serum and aqueous MMP-2/TIMP-2 system in patients with primary glaucoma.Complication of T2DM did not exacerbate this imbalance.
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