摘要目的 探讨微切口超声乳化术对白内障患者的临床治疗效果及其对患者泪液IL-6、TNF-α、表皮生长因子(EGF)表达的影响.方法 采用前瞻性研究,将284例白内障患者按照随机数字表法分为对照组(采用同轴常规切口超声乳化术)和观察组(同轴微切口超声乳化术),每组142例,比较两组患者手术中有效超声乳化时间及平均超声能量差异,并分别于术前(T0)、术后1周(T1)、术后2周(T2)、术后4周(T3)对两组患者裸眼视力恢复情况,眼表疾病指数(OSDI)、泪膜破裂时间(BUT),基础泪液分泌试验(SIt),角膜荧光素染色(FL)以及泪液中IL-6、TNF-α、EGF表达水平进行检测,并对以上各指标进行Spearman相关性分析.结果 两组在有效超声乳化时间及平均超声能量上差异无统计学意义(P＞0.05),观察组裸眼视力改善程度优于对照组,差异有统计学意义(F=6.116,P=0.032);两组在不同时间点下,OSDI、FL、IL-6、TNF-α、EGF指标均呈现先升高后下降趋势,且观察组优于对照组,差异有统计学意义(P＜0.05);同时,BUT及SIt呈现先下降后升高趋势,且观察组优于对照组,差异有统计学意义(P＜0.05);泪液中IL-6、TNF-α、EGF表达量分别与OS-DI、FL评分呈正相关(P＞0.05).结论 微切口超声乳化术有助于降低白内障患者术后IL-6、TNF-α水平,提高EGF水平以及减少术后干眼等不良症状发生率,从而提高临床治疗效果.

abstractsObjective To investigate the effect of micro-incision phacoemul-sification on cataract patients and its effect on interleukin (IL)-6, tumor necrosis factor-α (TNF-α), and epidermal growth factor (EGF) expressions in cataract patients.Methods With forward-looking research, 284 cataract patients were randomly included in the control (coaxial conventional incision phacoemulsification) or observation (coaxial micro-incision phacoemulsification) groups, with 142 cases per group.The effective phacoemulsification time and mean ultrasonic energy difference were compared between two groups, and the uncorrected vision recovery, Ocular Surface Disease Index (OSDI), tear break-up time (BUT), schirmer I test (SIt), corneal fluorescence stain (FL), and the expressionsIL-6, TNF-α and EGF were measured in two groups on preoperative (T0), 1 week after operation (T1), 2 weeks after operation (T2), 4 weeks after operation (T3), and the above indicators of Spearman correlation analysis.Results There was no significant difference in effective phacoemulsification time and mean ultrasonic energy between two groups (P ＞ 0.05).The improvement of uncorrected visual acuity in observation group was significantly better than that in the control group (F=6.116, P =0.032).In addition, OSDI, FL,IL-6,TNF-α, and EGF showed the first increase and then decreased at different time points, and the observation group was superior to the control group with statistically significant difference.At the same time, BUT and SIt showed a trend of increasing first and then decreased, and the observation group was superior to the control group with statistically significant difference.In addition, IL-6, TNF-α, and EGF expressions were positively correlated with OSDI and FL scores (P ＞ 0.05).Conclusions Micro-incision phacoemulsification can help reduce the expressions of IL-6 and TNF-α, improve the expression levels of EGF in cataract patients, and reduce the incidence of adverse symptoms such as dry eye after operation.It might improve the clinical therapeutic effect.