中华眼底病杂志

中华眼底病杂志

孔源性视网膜脱离合并脉络膜脱离患眼脉络膜上腔液成份定量分析

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目的 观察孔源性视网膜脱离合并脉络膜脱离(RRDCD)患眼脉络膜上腔液中总蛋白(TP)、乳酸脱氢酶(LDH)、白蛋白(ALB)、总胆固醇(CHOL)、总胆红素(TBIL)含量,初步探讨脉络膜上腔液性质。 方法 行玻璃体切割手术(PPV)治疗的RRDCD患者(RRDCD组)18例18只眼纳入研究。其中,男性10例10只眼,女性8例8只眼;均为单眼,其中右眼8只,左眼10只。年龄≤55岁8例;>55岁10例。病程≤30 d 7例;>30 d 11例。屈光度≥−6.0 D 7只眼,<−6.0 D 11只眼。增生性玻璃体视网膜病变(PVR)C、D级分别为11、7只眼。PPV中行脉络膜上腔穿刺收集脉络膜上腔液。手术当日抽取RRDCD患者外周静脉血。选取同期10例住院患者的10份外周静脉血标本作为对照组。分别检测RRDCD组、对照组患者血清标本以及RRDCD组患眼脉络膜上腔液标本中TP、LDH、ALB、CHOL、TBIL的浓度。以Light标准和ALB、CHOL、TBIL标准对脉络膜上腔液性质进行鉴定。 结果 脉络膜上腔液性质鉴定结果,Light标准:渗出液17份,漏出液1份;ALB标准:渗出液14份,漏出液4份;CHOL标准:渗出液18份,漏出液0份;TBIL浓度:渗出液16份,漏出液2份。Light标准与ALB、CHOL、TBIL标准脉络膜上腔液性质鉴定结果比较,差异均无统计学意义(χ2=2.090、1.029、0.364,P>0.05)。RRDCD组中,年龄≤55、>55岁以及不同性别、眼别、屈光度、PVR分级患眼之间脉络膜上腔液标本中TP、LDH、ALB、CHOL、TBIL浓度比较,差异均无统计学意义(P>0.05)。RRDCD组、对照组患者血清标本中TP、LDH、ALB、CHOL、TBIL浓度比较,差异无统计学意义(P>0.05)。RRDCD组患者血清标本与患眼脉络膜上腔液标本中ALB、CHOL、TBIL浓度比较,差异无统计学意义(P>0.05);TP、LDH浓度比较,差异有统计学意义(P<0.05)。 结论 RRDCD患眼脉络膜上腔液中含有TP、LDH、ALB、CHOL、TBIL;其性质为渗出液可能性大。

Objective To investigate the nature of the suprachoroidal fluid by detecting the concentration of total protein (TP), lactate dehydrogenase (LDH), albumin (ALB), total cholesterol (CHOL), total bilirubin (TBIL) in suprachoroidal liquid of patients who have rhegmatogenous retinal detachment with choroid detachment (RRDCD). Methods Eighteen RRDCD patients (18 eyes) who underwent vitrectomy were enrolled in this study. There were 10 males (10 eyes) and 8 females (8 eyes), 8 right eyes and 10 left eyes. There were 8 patients with age of ≤55 years, 10 patients with age of >55 years. There were 7 patients with duration of ≤30 days, 11 patients with duration of >30 days. There were 7 eyes with diopters of ≥−6.0 D, 11 eyes with diopters of <−6.0 D. There were 11 eyes with class C proliferative vitreoretinopathy (PVR), 7 eyes with class D PVR. Suprachoroidal fluid samples were collected from all the patients, and took preoperative serum samples as RRDCD group. Ten serum samples of normal people were set as control group. The concentration of TP, LDH, ALB, CHOL, TBIL in all the subjects were measured. The properties of the suprachoroidal fluid were identified by Light standard and concentration standard of ALB, CHOL, TBIL. Results There was no difference on the concentration of TP, LDH, ALB, CHOL, TBIL from suprachoroidal fluid samples in the patients with different age, sex, eyes, diopter, PVR grade (P>0.05). There was no difference on the concentration of TP, LDH, ALB, CHOL, TBIL from preoperative serum samples in the patients between RRDCD group and control group (P>0.05). There was no difference on the concentration of ALB and CHOL from suprachoroidal fluid samples and preoperative serum samples in the RRDCD patients (P>0.05), but there were significant differences on the concentration of TP, LDH, TBIL (P<0.05). According to the Light standard, there were 17 cases of exudates and 1 case of transudate. According to the concentration standard of ALB, CHOL and TBIL, there were 14, 18, and 16 cases of exudates, and 4, 0, and 2 cases of transudate, respectively. There was no difference on the identification result of Light standard and concentration standard of ALB, CHOL, TBIL (χ2=2.090, 1.029, 0.364; P>0.05). Conclusion The suprachoroidal fluid of RRDCD patients composed of TP, LDH, CHOL and TBIL. The suprachoroidal fluid is more likely to be exudate.

关键词: 视网膜脱离/病因学; 脉络膜疾病/病因学; 视网膜穿孔/并发症; 渗出液和滤出液

Key words: Retinal detachment/etiology; Choroid diseases/etiology; Retinal perforations/complications; Exudates and transudates

引用本文: 韩林峰, 柯根杰, 王林, 顾永昊, 顾起宏, 董凯, 刘家佳. 孔源性视网膜脱离合并脉络膜脱离患眼脉络膜上腔液成份定量分析. 中华眼底病杂志, 2017, 33(5): 485-489. doi: 10.3760/cma.j.issn.1005-1015.2017.05.011 复制

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