摘要目的 观察转甲状腺素蛋白(TTR)在高度近视患者血清及玻璃体中的异常表达.方法 经检影验光、裂隙灯显微镜和间接检眼镜眼底检查,Iol-Master测量眼轴后确诊的116例高度近视患者(患者组)纳入研究.其中,男性50例,女性66例;平均年龄(49.7±12.3)岁,平均屈光度(-10±4.4.2)D.选取同期健康检查者86名为正常对照组.其中,男性42名,女性44名;平均年龄(48.5±10.5)岁.根据间接检眼镜及光相干断层扫描(OCT)检察结果,将眼底病变分为黄斑中心凹脱离、黄斑裂孔、脉络膜新生血管、黄斑表面膜、瘢痕萎缩、眼底未见明显病理改变等情况.所有受试者抽取外周静脉血2 ml,制备血清样本.另外选择合并黄斑中心凹脱离、黄斑裂孔的高度近视患者20例20只眼,行玻璃体切割手术前采集玻璃体样本.患者组、正常对照组各选取16份血清样本进行线性离子阱质谱(LTQ-MASS)分析.并采用蛋白免疫印迹(Western blot)及酶联接免疫吸附测定(ELISA)方法对患者组100份血清和正常组80份血清中TTR含量进行测定.再对玻璃体样本20份和对应血清样本进行ELISA检测,同时观察手术后视力与玻璃体中TTR含量之间的关系.结果 患者组和正常对照组血清样本LTQ-MASS检测出4种差异蛋白.其中,患者组TTR含量较正常对照组TTR含量明显升高.Western blot检测结果显示,患者组血清中TTR表达较正常对照组血清TTR表达明显增高,差异有统计学意义(t=3.68,P＜0.05).ELISA检测结果显示,患者组中伴黄斑脱离及黄斑裂孔者血清和玻璃体中TTR含量明显高于正常对照组,差异有统计学意义(F=9.28,P＜0.01).手术后视力恢复较好者玻璃体中TTR含量较高.结论 TTR在高度近视患者血清及玻璃体中表达较正常组明显增高,且与高度近视眼底表现相关.

abstractsObjective To observe the abnormal expression of transthyretin in serum and vitreous of high myopia patients.Methods 116 patients(50 males and 66 females)with high myopia,diagnosed by retinoscopic reflex,slit-lamp microscope,indirect ophthalmoscope and Iol-Master,were enrolled.The patients had an average age of(49.7±12.3)years and average diopter of(-10±4.2)D.The control group had 86 healthy individuals(42 males and 44 females)with an average age of(48.5±10.5)years.According to the findings of indirect ophthalmoscope and optical coherence tomography(OCT)examination,the patients were classified as foveal detachment,macular hole,choroidal neovascularization,epimacular membrane.retinal scar and no significant pathological changes.2 ml peripheral blood samples were taken from all the subjects.The vitreous samples of high myopia patients with foveal detachment and macular hole (20 patients.20 eyes)were collected before pars plana vitrectomy.LTQ-MASS was performed on 16 serum samples of patients and 16 control serum samples.Western blot and enzyme linked immunosorbent assay (ELISA)were used to detect serum transthyretin expression in high myopia groups(n=100)and control group(n=80).Vitreous samples(n=20)and corresponding serum samples were further analyzed by ELlSA.Meanwhile,the relationship between visual acuity after surgery and transthyretin expression level in vitreous were analyzed.Results LTQ-MASS detected 4 proteins differentially expressed in the serum of patients and control group,transthyretin was the most significantly increased protein in high myopia patients.Western blot validated that serum transthyretin of high myopia group was much higher than that of the control group(t=3.68,P＜0.05).High myopia patients with macular hole and macular detachment had much higher serum and vitreous transthyretin than that of control group(F=9.28,P＜0.01).Patients with higher vitreous transthyretin had better postoperative visual acuity.Conclusions The transthyretin level increases significantly in serum and vitreous of high myopia patients,and it correlated with ocular pathologies and visual outcomes.