外伤性白内障房水中炎症因子含量的测定及手术方式的研究

发布时间：2018-04-15 07:23

本文选题：外伤性白内障 + 炎症因子　；参考：《安徽医科大学》2015年博士论文

【摘要】：目的：1、通过测定炎症因子白介素-6(IL-6)、转化生长因子-β(TGF-β)、成纤维细胞生长因子(FGF)和血管内皮生长因子(VEGF)在外伤性白内障患者房水中的含量变化,了解上述炎症因子与外伤性白内障之间的关系。2、分析我院接诊的外伤性白内障患者的构成,了解OTS眼外伤评分系统在外伤性白内障术后视力预测中的价值。比较人工晶体一期植入和二期植入的结果。在外伤性白内障术后无晶体眼的治疗上,报道一种新的两点式人工晶体睫状沟悬吊固定的手术方式。方法：第一部分：选择外伤后(10.90±1.41)天的外伤性白内障患者(A组)21例进行房水中炎症因子的检测,同时选择我科住院手术的年龄相关性白内障患者20名(20只眼,B组)和需要做前房穿刺的高度近视眼后巩膜加固术患者20名(20只眼,C组)作为对照组。抽取三组患者的房水,应用酶联免疫吸附测定法(ELISA)测定A、B、C三组房水中IL-6.TGF-β、FGF、VEGF的含量,对三组数据进行比较,了解外伤性白内障患者伤后房水中这些炎症因子含量的变化情况。第二部分：采用回顾性队列研究,收集2008年10月到2013年12月在我科就诊并手术的104例外伤性白内障患者的临床资料。分析这组患者的病因学构成,用OTS眼外伤评分系统对上述患者进行评分,将预测视力和实际视力做比较,评估OTS系统对视力预测的准确性。将104例外伤性白内障患者按一期和二期植入人工晶体分为A、B两组,比较两组间术后视力、并发症之间的差异。选择外伤性白内障术后无足够囊膜支撑的无晶体眼患者16例。经巩膜两点法固定植入折叠型-片式后房型的人工晶体。测术后3天、1周、1月、6月和24个月的视力、等效球镜(SE)和角膜内皮细胞计数(ECC),超声生物显微镜(UBM)检查晶体位置。结果：第一部分：A组房水中工L-6含量均比B、C两组升高,差异具有统计学意义。A组房水中TGF-β含量均比B、C两组升高,差异具有统计学意义。A、B、C组房水中FGF的含量相比均无统计学差异。A组房水中VEGF含量均比B、C两组升高,差异具有统计学意义。第二部分：OTS评分系统在指数～0.1和≥0.5视力组的预测灵敏度都达到100%,0.1～0.5视力组灵敏度91.9%,特异度100%。一期和二期植入人工晶体术后视力不同,差异有统计学意义。两组患者的并发症比较无统计学差异。两点睫状沟悬吊固定四襻式人工晶体术后最佳矫正视力比术前提高,结果有统计学差异。术前和术后的等效球镜、角膜内皮计数均无明显变化。术后并发症方面未见感染、晶体移位、缝线暴露、视网膜脱离、眼内炎,发生2例黄斑部水肿(12.5%)。结论：闭合性眼外伤引起的外伤性白内障患者房水中IL-6、TGF-βVEGF含量较正常人升高；FGF的含量与正常比较无明显变化。OTS评分系统对外伤性白内障有良好的视力预测作用。外伤性白内障的手术治疗中一期和二期植入人工晶体术后视力不同,但二者术后并发症比较无差异。对于无足够囊膜支撑的外伤性白内障术后无晶体眼,经巩膜两点法固定四襻式人工晶体是一种安全、有效的方法。
[Abstract]:Objective : To investigate the changes of inflammatory factors in patients with traumatic cataract after traumatic cataract . The results showed that the contents of IL - 6 , TGF - 尾 , FGF and VEGF in the patients with traumatic cataract were compared with those of patients with traumatic cataract after traumatic cataract . The results showed that the contents of L - 6 and L - 6 were higher in group A and group A than in group B and C . There was no significant difference between the two groups . There was no significant difference between the two groups . There was no significant difference between the two groups . There were no significant differences between the two groups . There were no significant differences in the postoperative complications between two groups . Conclusion : The IL - 6 and TGF - 尾VEGF levels in the patients with traumatic cataract caused by closed eye trauma were higher than those in normal controls .
There was no significant change in the content of FGF in traumatic cataract . There was no difference in postoperative visual acuity between the first and second stages in the surgical treatment of traumatic cataract , but no difference was found between the two postoperative complications .

【学位授予单位】：安徽医科大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R779.66

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