摘要
目的 分析剥脱性青光眼(PXG)患者眼压与外周血液各项指标之间的关系.方法 回顾性队列研究.纳入喀什地区第一人民医院眼科 2019 年 1 月至 2020 年 10 月住院治疗的假性剥脱综合症(PEX)171 例(171 眼).根据是否出现PXG将其分为两组,其中PXG组 78 例(78 眼),非假性剥脱青光眼(NPXG)组 93 例(93 眼).所有患者均进行眼科常规检查,入院次日清晨抽取外周静脉血进行血清学检查.检测乳酸脱氢酶、红细胞计数、血红蛋白定量、中性粒细胞计数、淋巴细胞计数、血小板计数、单核细胞计数比值.结果 PXG组眼压为 33.5(21.5)mmHg(1 mmHg=0.133 kPa),NPXG组眼压为 16.0(3.0)mmHg,两组差异有统计学意义(Z=-9.38,P<0.001).PXG组乳酸脱氢酶水平(192.45±27.69)U/L高于NPXG组的(177.54±27.40)U/L,差异具有统计学意义(t=3.53,P=0.001);PXG组尿素氮水平(5.72±1.27)mmol/L低于NPXG组的(6.28±1.60)mmol/L,差异具有统计学意义(t=-2.53,P=0.012);PXG 组单核细胞计数(0.48±0.14)109/L 高于 NPXG 组的(0.43±0.13)109/L,差异具有统计学意义(t=2.13,P=0.035).中性粒细胞与淋巴细胞计数比值PXG组 1.93±0.72,NPXG组 1.71±0.57;淋巴细胞与单核细胞计数比值PXG组 4.49±1.47,NPXG组5.05±1.38,差异均存在统计学意义(均P<0.05).Spearman相关性分析表明眼压与乳酸脱氢酶呈正相关(ρ=0.18,P=0.019).乳酸脱氢酶的受试者操作特征曲线下面积为 0.653,最佳临界值为182.50 U/L,敏感性为 62.42%,特异性为 62.40%.结论 PXG患者眼压与外周血清中乳酸脱氢酶水平显著正相关.作为氧化应激和缺血缺氧的非特异性标志物,外周血清中乳酸脱氢酶水平升高是PXG患者的临床特征之一.
Abstract
Objective To analyze the relationship between intraocular pressure(IOP)and peripheral blood parameters in patients with pseudoexfoliation glaucoma(PXG).Methods This was a retrospective cohort study.A total of 171 cases(171 eyes)of pseudoexfoliation syndrome in the First People's Hospital of Kashgar,from Jan.2019 to Oct.2020.Patients were divided into two groups based on the presence of PXG:PXG group(78 patients,78 eyes)and non-pseudoexfoliation glaucoma(NPXG)group(93 patients,93 eyes).All patients underwent routine ophthalmic examinations,and peripheral venous blood samples were collected for serological examination on the morning after admission.Level of lactate dehydrogenase,red blood cell count,hemoglobin concentration,neutrophil count,lymphocyte count,platelet count,and monocyte count were measured.Results The IOP in the PXG group was 33.5(21.5)mmHg(1 mmHg=0.133 kPa),which was significantly higher than the 16.0(3.0)mmHg in the NPXG group(Z=-9.38,P<0.001).The LDH in the PXG group was(192.45±27.69)U/L,which was higher than the(177.54±27.40)U/L in the NPXG group,with statistical significance(t=3.53,P=0.001);the urea nitrogen level in the PXG group was(5.72±1.27)mmol/L,which was lower than the(6.28±1.60)mmol/L in the NPXG group,with statistical significance(t=-2.53,P=0.012);the monocyte count in the PXG group was(0.48±0.14)109/L,which was higher than the(0.43±0.13)109/L in the NPXG group,with statistical significance(t=2.13,P=0.035).The neutrophil-to-lymphocyte ratio was 1.93±0.72 in the PXG group and 1.71±0.57 in the NPXG group,while the lymphocyte-to-monocyte ratio was 4.49±1.47 in the PXG group and 5.05±1.38 in the NPXG group,both showing statistical significance(all P<0.05).Spearman correlation analysis showed a positive correlation between IOP and LDH(ρ=0.18,P=0.019).The area under the receiver operating characteristic curve for LDH was 0.653,with an optimal cutoff value of 182.50 U/L,sensitivity of 62.42%,and specificity of 62.40%.Conclusion Serum LDH level is significantly positively correlated with IOP in patients with PXG.Elevated serum LDH level is one of the clinical characteristics of PXG,reflecting oxidative stress and ischemia-hypoxia.
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