广西医学

目的探讨脑源性神经营养因子（BDNF）、白细胞介素37（IL-37）、可溶性CD44（sCD44）在原发性开角型青光眼患者房水中的表达水平及其诊断价值。方法选45例（45只眼）原发性开角型青光眼患者作为观察组，纳入同期收治的45例（45眼）白内障患者作为对照组。根据视野平均缺损（MD）值评估观察组患者视神经损伤程度，并将患者分成轻度组24例（24眼）、中度组12例（12眼）、重度组9例（9眼）。比较观察组与对照组之间，以及轻度组、中度组及重度组之间的房水BDNF、IL-37、sCD44表达水平。采用受试者工作特征曲线分析房水BDNF、IL-37、sCD44表达水平单独及三者联合对原发性开角型青光眼的诊断价值。采用Pearson检验分析观察组患者房水BDNF、IL-37、sCD44表达水平之间的相关性。结果观察组房水IL-37、sCD44表达水平高于对照组，BDNF表达水平低于对照组；重度组患者房水IL-37、sCD44表达水平高于中度组、轻度组，BDNF表达水平低于中度组、轻度组（P＜0.05）。房水BDNF、IL-37、sCD44表达水平联合诊断原发性开角型青光眼的曲线下面积为0.886，高于房水BDNF、IL-37、sCD44表达水平单独诊断的曲线下面积（P＜0.05）。观察组患者房水中IL-37的表达水平与sCD44的表达水平呈正相关，BDNF表达水平与IL-37、sCD44表达水平呈负相关（P＜0.05）。结论原发性开角型青光眼患者房水IL-37、sCD44表达水平升高，BDNF表达水平下降，联合检测房水BDNF、IL-37、sCD44表达水平在原发性开角型青光眼中的诊断价值较高，且三者的表达水平具有一定的相关性。

ObjectiveTo explore the expressions and diagnostic value of brain-derived neurotrophic factor (BDNF), interleukin 37 (IL-37), and soluble CD44 (sCD44) in aqueous humor of patients with primary open-angle glaucoma. MethodsForty-five patients (45 eyes) with primary open-angle glaucoma were selected as observation group, simultaneously, 45 cataract patients (45 eyes) admitted and treated during the same period were enrolled as control group. The degree of optic nerve injury in patients of the observation group was evaluated according to the mean defect of visual field (MD) value, and patients were divided into mild group (n=24, 24 eyes), moderate group (n=12, 12 eyes), or severe group (n=9, 9 eyes). The expressions of BDNF, IL-37, and sCD44 in aqueous humor were compared between the observation group and the control group, and between the mild, moderate and severe groups. The diagnostic value of aqueous humor BDNF, IL-37, sCD44 expressions alone, and their combination for primary open-angle glaucoma was analyzed by using the receiver operating characteristic curve. The Pearson test was used to analyze the correlation between BDNF, IL-37, and sCD44 expressions in aqueous humor of patients in the observation group. ResultsThe expressions of IL-37 and sCD44 in aqueous humor of the observation group were higher than those of the control group, and the expression of BDNF was lower than that of the control group; furthermore, the expressions of IL-37 and sCD44 in aqueous humor in the severe group were higher than those in the moderate and mild groups, and the expression of BDNF was lower than that in the moderate and mild groups (P＜0.05). The areas under the curve of the combination of BDNF, IL-37, and sCD44 expressions in aqueous humor for diagnosing primary open-angle glaucoma was 0.886, which was higher than the areas under the curve of the single diagnosis of BDNF, IL-37, and sCD44 expressions in aqueous humor (P＜0.05). There was a positive correlation between IL-37 and sCD44 expressions in aqueous humor in the observation group, while BDNF expression negatively correlated with IL-37 and sCD44 expressions in the observation group (P＜0.05). ConclusionThe expressions of IL-37 and sCD44 in aqueous humor are elevated, while BDNF expression is decreased in patients with primary open-angle glaucoma. The combined detection of BDNF, IL-37, and sCD44 expressions in aqueous humor exerts a relatively high diagnostic value in primary open-angle glaucoma, and the expressions of the three are correlated to a certain extent.