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目的:评估新生血管性青光眼(NVG)闭角期患者房水内细胞因子浓度的变化并分析其与复发的关系。方法:前瞻性病例对照研究。收集2018年9月至2019年9月就诊于北京大学第三医院眼科的32例(32只眼)NVG闭角期患者(NVG组),所有患者均接受包含抗血管内皮生长因子(VEGF)药物注射、小梁切除术和全视网膜光凝在内的三联序贯治疗并随访至少12个月。NVG组患者在抗VEGF药物注射前、小梁切除术前及NVG复发时收集房水标本,采用流式点阵免疫发光法检测VEGF、白细胞介素(IL)、趋化因子等45种细胞因子的浓度。选取25例增生型糖尿病视网膜病变(PDR)患者(PDR组)和24例年龄相关性白内障患者(白内障组)作为疾病对照组。细胞因子浓度以n M(n Q1,n Q3)表示,NVG组与疾病对照组间细胞因子浓度比较采用非参数Kruskal-Wallisn H检验;NVG复发与未复发患者间细胞因子浓度比较采用Mann-Whitney n U检验。n 结果:NVG组年龄(60±11)岁,男性22例,女性10例;年龄和性别分布与两个疾病对照组相比差异均无统计学意义(均n P>0.05)。NVG组在抗VEGF治疗前、小梁切除术前、复发时房水中VEGF浓度分别为2 151.3(1 433.1,4 280.0)、655.4(287.3,836.3)、2 003.4(1 603.1,2 468.9)ng/L,抗VEGF治疗前和复发时均高于PDR组[453.8(189.9,595.8)ng/L]和白内障组[143.5(112.7,269.8)ng/L],差异均有统计学意义(均n P<0.05)。NVG组在抗VEGF治疗前房水中细胞程序性死亡蛋白-配体1(PD-L1)浓度[38.9(22.4,50.6)ng/L]高于PDR组[12.0(6.3,20.1)ng/L]和白内障组[14.6(11.4,19.3)ng/L];CX3C型趋化因子配体1(fractalkine)浓度[242.7(189.0,306.7)ng/L]高于PDR组[131.1(119.1,157.6)ng/L]和白内障组[116.7(10.2,135.9)ng/L];IL-7浓度[18.0(12.0,32.7)ng/L]高于PDR组[7.7(2.0,10.8)ng/L]和白内障组[3.3(1.9,6.8)ng/L];嗜酸粒细胞趋化因子(eotaxin)浓度[84.0(52.4,122.7)ng/L]高于PDR组[26.6(17.1,72.3)ng/L]和白内障组[7.1(5.6,14.8)ng/L];肿瘤坏死因子相关凋亡诱导配体(TRAIL)浓度[3.6(2.8,6.4)ng/L]高于白内障组[1.1(0.3,2.3)ng/L],差异均有统计学意义(均n P0.05)。6例NVG患者在随访期复发,复发患者在抗VEGF治疗前房水中IL-7浓度为10.5(8.4,16.0)ng/L低于未复发患者治疗前的22.7(15.7,34.1)ng/L,差异有统计学意义(n Z=-2.74;n P0.05). The median concentrations of VEGF in the NVG group before anti-VEGF treatment, before trabeculectomy, and after recurrence were 2 151.3 (1 433.1, 4 280.0) ng/L, 655.4 (287.3, 836.3) ng/L and 2 003.4 (1 603.1, 2 468.9) ng/L respectively. The concentrations of VEGF before anti-VEGF treatment and after recurrence in the NVG group were significantly higher than the PDR group [453.8 (189.9, 595.8) ng/L] and the cataract group [143.5 (112.7, 269.8) ng/L] (alln P<0.05). The median concentration of programmed cell death protein ligand 1 (PD-L1) was 38.9 (22.4, 50.6) ng/L before anti-VEGF treatment, higher than that in the PDR group [12.0 (6.3, 20.1) ng/L] and the cataract group [14.6 (11.4, 19.3) ng/L]. The median concentration of fractalkine was 242.7 (189.0, 306.7) ng/L, higher than that in the PDR group [131.1 (119.1, 157.6) ng/L] and the cataract group [116.7 (10.2, 135.9) ng/L]. The median concentration of IL-7 was 18.0 (12.0, 32.7) ng/L, higher than that in the PDR group [7.7 (2.0, 10.8) ng/L] and the cataract group [3.3 (1.9, 6.8) ng/L]. The median concentration of eotaxin was 84.0 (52.4, 122.7) ng/L, higher than that in the PDR group [26.6 (17.1, 72.3) ng/L] and the cataract group [7.1 (5.6, 14.8) ng/L]. The median concentration of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) was 3.6 (2.8, 6.4) ng/L, higher than that in the cataract group [1.1 (0.3, 2.3) ng/L]. All the differences were statistically significant (alln P0.05). Six NVG patients suffered recurrence during the follow-up. The baseline concentration of IL-7 of these patients [10.5 (8.4, 16.0) ng/L] was significantly lower than that in patients who did not have recurred disease [22.7 (15.7, 34.1) ng/L] (n Z=-2.74, n P<0.01).n Conclusions:In the angle-closure stage of NVG patients, the concentrations of VEGF, PD-L1, fractalkine, IL-7, eotaxin, and TRAIL in the aqueous humor significantly increase during the onset of disease. Lower IL-7 may indicate a recurring tendency.