于世伟,夏媛玲
YU Shiwei,XIA Yuanling

• 1:贵州医科大学
• 2:贵州医科大学附院

摘要(Abstract)：

目的:探讨肝素人工晶状体(HSM)对糖尿病(DM)白内障患者超声乳化及人工晶状体植入术后房水NO水平的影响。方法:42例行白内障超声乳化吸除联合人工晶状体植入术的糖尿病患者,分为非肝素人工晶状体植入组(NHSM组,n=12)和肝素人工晶状体植入组(HSM组,n=30);比较术前、术后第3及14天的最佳矫正视力(LogMAR),术后第3及14天时前房闪辉及房水细胞,术前和术后第3天时患眼房水中NO水平,记录两组患者术中及术后并发症。结果:两组患者术前、术后第3及14天的LogMAR比较,差异无统计学意义(P>0.05);术后第3天时,NHSM组前房闪辉及房水细胞高于HSM组(P<0.05);术后第14天两组前房闪辉和房水细胞均明显减少,但2组比较差异无统计学意义(P>0.05);术前两组患眼房水中NO浓度比较,差异无统计学意义(P>0.05);术后第3天时,与同组术前比较,两组患眼房水中NO水平降低,但仅HSM组差异有统计学意义(P<0.05),NHSM组患眼房水中NO水平高于HSM组(P<0.05);两组患者术中及术后无并发症发生。结论:DM白内障患者超声乳化术后植入HSM可减轻术后炎症反应。
Objective: To investigate the effect of heparin surface-modified intraocular lens( HSM)on aqueous humor NO level in diabetic patients with cataract phacoemulsification and intraocular lens implantation. Methods: 42 diabetic patients who underwent cataract phacoemulsification and intraocular lens implantation were divided into two groups: non HSM group( group NHSM,n = 12) and HSM group( groupHSM,n = 30). The best corrected visual acuity( LogMAR) was compared before surgery and on the 3~(rd) and 14~(th) day after surgery. On the 3~(rd) and 14~(th) day after surgery,anterior chamber flare and aqueous humor cells were compared. Aqueous humor NO level was compared before surgery and on the 3~(rd) day after surgery. The intraoperative and postoperative complications of the two groups were recorded. Results: LogMAR between the two groups were compared before surgery and on the 3~(rd) and 14~(th) day after surgery,the differences were not statistically significant( P > 0. 05). On the 3~(rd) day after surgery,anterior chamber flare and aqueous humor cells in group NHSM were more obvious than those in groupHSM( P < 0. 05),and they significantly reduced on the 14~(th) day after surgery,the differences between the two groups were not statistically significant( P > 0. 05). The difference of aqueous humor NO level between the two groups was not statistically significant before surgery( P > 0. 05). On the 3~(rd) day after surgery,compared with the same group before surgery,aqueous humor NO level reduced in the two groups,but only the difference of HSM group was statistically significant( P < 0. 05). Aqueous humor NO level in group NHSM was higher than that in group HSM on the 3~(rd) day after surgery( P <0. 05). No complications occurred during and after surgery in the two groups. Conclusion: HSM can reduce the inflammatory reaction after diabetic cataract phacoemulsification.

关键词(KeyWords)： 糖尿病;一氧化氮;炎症;肝素人工晶状体;最佳矫正视力
diabetes;nitric oxide;inflammation,heparin surface-modified intraocular lens;best corrected visual acuity

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 于世伟,夏媛玲
YU Shiwei,XIA Yuanling

DOI: 10.19367/j.cnki.1000-2707.2017.08.016

参考文献(References)：

• [1]葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013:733.
• [2]孙堂胜.糖尿病患者白内障术后的急性前房反应[J].国际眼科杂志,2009(1):172-174.
• [3]陈玲,张业顶,马子杰.糖尿病患者白内障摘除联合后房型人工晶状体植入的临床分析[J].临床眼科杂志,2002(4):356-357.
• [4]张少斌,徐珊琪.糖尿病患者白内障摘除人工晶体植入的疗效观察[J].广东医学,1999(2):92-93.
• [5]李筱荣,洪克晋.糖尿病患者白内障囊外摘除与人工晶体植入术疗效分析[J].中国实用眼科杂志,1998(11):666-667.
• [6]韩琪,张福昆.Ⅱ型糖尿病患者人工晶体植入术并发症探讨[J].中国实用眼科杂志,1998(7):439-441.
• [7]蒋波,楚正绪.一氧化氮与炎症[J].国外医学生理、病理科学与临床分册,1998(1):44-47.
• [8]邱海波,陈德昌.一氧化氮生物作用的两面性与多器官功能障碍综合征[J].基础医学与临床,1998(1):11-14.
• [9]Rogers NM,Isenberg JS.Seeing is believing:NO therapy for glaucoma?Focus on"Role of nitric oxide in murine conventional outflow physiology"[J].American Journal of Physiology Cell Physiology,2015(4):C203.
• [10]Cavet ME,Vittitow JL,Impagnatiello F,et al.Nitric oxide(NO):an emerging target for the treatment of glaucoma[J].Investigative Ophthalmology&Visual Science,2014(8):5005-5015.
• [11]Yuksel N,Ozel-Turkcu U,Yalinbas D,et al.Comparison of Aqueous Humor Nitric Oxide Levels After Different Corneal Collagen Cross-Linking Methods[J].Current Eye Research,2016(12):1539-1542.
• [12]Borgioli M,Coster DJ,Fan RF,et al.Effect of heparin surface modification of polymethylmethacrylate intraocular lenses on signs of postoperative inflammation after extracapsular cataract extraction:one-year results of a double-masked multicenter study[J].Ophthalmology,1992(8):1254-1255.
• [13]路晓明,周少博,程浩,等.肝素修饰人工晶体在糖尿病白内障超声乳化术中的应用[J].医学信息旬刊,2010(5):68.
• [14]刘涛,胡爱华,胡庆军,等.肝素表面修饰可折叠亲水性丙烯酸酯人工晶状体对白内障术后炎症反应影响的评测[J].国际眼科杂志,2016(1):11-13.
• [15]管怀进.我国防盲与眼科流行病学研究的现状及发展[J].中华眼科杂志,2010(10):938-943.
• [16]刘家琦,李凤鸣.实用眼科学[M].3版.北京:人民卫生出版社,2010:323.
• [17]赵堪兴,杨培增.眼科学[M].8版.北京:人民卫生出版社,2013:150.
• [18]Guan HJ.Present status and development of prevention of blindness and ophthalmic epidemiologic studies in China[J].Chinese journal of ophthalmology,2010(10):938-943.
• [19]李琦文.糖尿病性视网膜病变的研究进展[J].航空航天医学杂志,2014(12):1708.
• [20]贾淑琴,霍建新.糖尿病性视网膜病变相关研究[J].包头医学院学报,2014(4):138-140.
• [21]孙文涛,张小玲,高嵩,等.糖尿病性视网膜病变发生发展的相关因素[J].国际眼科杂志,2005(4):755-759.
• [22]刘罡,段俊国,张富文,等.2型糖尿病病程与视网膜病变的相关性[J].现代医药卫生,2004(2):79-80.
• [23]刘逸.肝素处理人工晶体在糖尿病白内障手术中的应用[J].中外医疗,2011(3):6-7.
• [24]Krall EM,Arlt EM,Jell G,et al.Intraindividual aqueous flare comparison after implantation of hydrophobic intraocular lenses with or without a heparin-coated surface[J].Journal of Cataract&Refractive Surgery,2014(8):1363-1370.
• [25]吴限亮.白内障患者血清、房水及泪液IL-2、s IL-2R、NO、TAC及SOD的变化[J].海南医学院学报,2014(8):1141-1143.
• [26]祁明信,黄秀榕,沈世仁,等.兔晶状体摘除和人工晶状体植入术后房水细胞因子水平和一氧化氮含量与眼内炎性反应的关系[J].中华眼科杂志,2003(1):41-43.

文章评论(Comment)：