小梁切除术分别联合Ologen植入与丝裂霉素C治疗青光眼的疗效及对血清细胞因子水平的影响

摘要

目的:探讨小梁切除术分别联合Ologen植入与丝裂霉素C治疗青光眼的疗效及对血清细胞因子水平的影响.方法:选取2013年3月至2016年12月陕西省汉中市中医医院收治的青光眼患者100例(112眼),按照随机数字表法分为研究组(50例,58眼)和对照组(50例,54眼).研究组采用小梁切除术联合Ologen植入治疗,对照组采用小梁切除术联合丝裂霉素C治疗.比较两组患者眼压、手术疗效及术后并发症发生率差异,并观察两组术前、术后外周血白介素(IL)-2、IL-6及血管内皮生长因子(VEGF)水平变化.结果:两组术后IL-2、IL-6水平均较术前明显升高,VEGF较术前降低,且研究组术后血清IL-2水平高于对照组,VEGF水平低于对照组,差异均具有统计学意义(均P＜0.05).两组患者术后眼压均较术前明显降低(均P＜0.05),但两组眼压比较,差异无统计学意义(P＞0.05).研究组手术成功率为97.06％,对照组为90.62％,两组比较差异无统计学意义(P＞0.05).两组并发症发生率比较,差异无统计学意义(P＞0.05).结论:小梁切除术联合Ologen植入与联合丝裂霉素C治疗青光眼的手术成功率相当,在并发症发生率方面亦无明显差异,但小梁切除术联合Ologen植入在改善患者血清IL-2、IL-6、VEGF水平,促进疾病恢复方面起到更好的作用.%Objective:To investigate the efficacy of trabeculectomy combined with Ologen implantation or mitomycin C in the treatment of glaucoma and its effect on serum cytokine levels.Methods:100 cases (112 eyes) of glaucoma patients admitted in our hospital from March 2013 to December 2016 were randomly divided into a study group (50 cases,68 eyes) and a control group (50 cases,64 eyes).The patients in the study group received trabeculectomy combined with Ologen implantation,and those in the control group received trabeculectomy combined with mitomycin C.The levels of interleukin-2 (IL-2),IL-6 level,vascular endothelial growth factor (VEGF),intraocular pressure,surgical efficacy and postoperative complications were compared.Results:The levels of IL-2 and IL-6 in both groups were significantly increased after treatment,but VEGF level was decreased.The level of IL-2 in the study group was higher than that in the control group after surgery,whereas the VEGF level was lower (P＜0.05).The intraocular pressure was significantly decreased in both groups after surgery (P＜ 0.05),but there was no significant difference between the two groups (P＞0.05).The total response rate was 97.06％ in the study group,and was 90.62％ in the control group.There was no significant difference in total response rate and the incidence of complications between the two groups (P＞0.05).Conclusion:Trabeculectomy combined with Ologen implantation could improve the serum cytokine levels and promote the recovery of patients.