目的：评估汉族和哈萨克族原发性闭角型青光眼(PACG)患者房水及小梁组织中转化生长因子β2(TGF-β2)表达水平及小梁切除术后滤过泡形成情况。

方法：前瞻性研究。选取2018-07/2019-04在石河子大学医学院第一附属医院眼科就诊的PACG患者46例49眼，其中汉族25例26眼，哈萨克族21例23眼，均于小梁切除术中采集房水和小梁组织，采用ELISA法检测房水总TGF-β2(tTGF-β2)和活化TGF-β2(aTGF-β2)含量，并通过免疫组化和免疫荧光法检测小梁组织中TGF-β2的表达。

结果：免疫组化和免疫荧光染色结果显示，汉族患者小梁组织中TGF-β2表达明显高于哈萨克族患者。ELISA定量分析显示，汉族和哈萨克族患者房水中aTGF-β2含量(172.015±79.367、83.436±41.743pg/mL)有明显差异(t=4.794，P<0.001)，且年龄≥70岁的两民族患者房水中tTGF-β2含量(480.124±152.997、338.858±72.497pg/mL)有差异(t=2.421，P=0.026)。术后两民族患者眼压均较术前明显降低，但术后6mo汉族和哈萨克族患者功能性滤过泡(Ⅰ、Ⅱ型滤过泡)形成情况有明显差异(50% vs 78%； χ²=4.841，P=0.028)。

结论：汉族与哈萨克族PACG患者房水及小梁组织中TGF-β2的表达具有差异性，哈萨克族患者房水和小梁组织中TGF-β2呈明显低表达，可能减少术后滤过泡瘢痕化，促进功能性滤过泡形成。

METHODS: Prospective research. Between July 2018 to April 2019, 46 PAGG patients(49 eyes)underwent trabeculectomy in our hospital, including 25 Han nationality(26 eyes)and 21 Kazak nationality(23 eyes). Aqueous humor and trabecular tissue were obtained through trabeculectomy. ELISA method was used to detect the content of total aqueous TGF-β2(tTGF-β2)and activated TGF-β2(aTGF-β2). And the expression of TGF-β2 in trabecular tissue was detected by immunohistochemistry and immunofluorescence.

RESULTS:Immunohistochemical staining and immunofluorescence staining showed that the expression of TGF-β2 in the trabecular meshwork of Han patients was significantly higher than that of Kazakh patients. ELISA quantitative analysis showed that the aTGF-β2 content of Han and Kazak patients were 172.015±79.367pg/mL and 83.436±41.743pg/mL, respectively, the difference was statistically significant(t=4.794, P<0.001). In patients ≥70 years old, the content of tTGF-β2 in the aqueous humor of patients of the two nationalities was 480.124±152.997 and 338.858±72.497pg/mL, respectively, the difference was statistically significant(t=2.421, P=0.026). In the comparison between preoperative and postoperative, there were time differences and interaction effects in intraocular pressure between Han and Kazak patients. At 6mo postoperatively, the formation of type Ⅰ and Ⅱ filter blebs in Han and Kazak patients was different, and the difference was statistically significant(50% vs 78%; χ²=4.841, P=0.028).

CONCLUSION: The expression of TGF-β2 in the aqueous humor and trabecular meshwork of patients with PACG in the two ethnic groups is different. The expression of TGF-β2 in the aqueous humor and trabecular meshwork of Kazakh patients is significantly lower, which reduces the promotion of postoperative filtering scar Functional filtration filtration bleb.