目的：观察年龄相关性白内障合并糖尿病性视网膜病变(DR)患者房水中白细胞介素-23(IL-23)和白细胞介素-17(IL-17)的表达水平及二者的相关性。

方法：收集2016-06/2019-06我院眼科收治的因年龄相关性白内障需行白内障手术的患者70例70眼，其中单纯年龄相关性白内障患者20例(Ⅰ组)，年龄相关性白内障合并单纯糖尿病者18例(Ⅱ组)，合并非增殖性糖尿病性视网膜病变者17例(Ⅲ组)，合并增殖性糖尿病性视网膜病变者15例(Ⅳ组)。采用ELISA法检测各组患者房水中IL-23、IL-17表达水平。

结果：四组患者房水中IL-23的表达水平分别为22.18±5.48、37.63±4.52、45.06±4.64、68.89±6.11pg/mL，IL-17的表达水平分别为4.69±2.03、6.83±1.02、9.52±1.30、10.89±1.26pg/mL，房水中IL-23和IL-17的表达水平随着DR的严重程度呈增高趋势，且糖尿病患者房水中IL-17的表达水平与IL-23呈正相关。

结论：房水中IL-23和IL-17的高表达可能协同促进DR的发生发展，IL-23/IL-17通路作为致病因素，可能通过加重视网膜炎症反应参与DR的病理损伤过程，这为DR的早期诊断和治疗提供了新的靶点。

METHODS: From June 2016 to June 2019, 70 patients(70 eyes)for age related cataract surgery were enrolled in Hubei Yichang Central People's Hospital. All cases were graded into 4 groups, includingⅠ group(20 cases): the control group(patients without diabetes), Ⅱ group(18 cases): diabetic patients without retinopathy, Ⅲ group(17 cases): diabetic patients with non-proliferative diabetic retinopathy, Ⅳ group(15 cases): diabetic patients with proliferative diabetic retinopathy. The levels of IL-23 and IL-17 in AH of the four groups were tested by Enzyme-linked immunosorbent assay(ELISA)and statistically analyzed by ANOVA respectively. The correlations between IL-17 and IL-23 were calculated by Person correction analysis.

RESULTS: The concentration of IL-23 in Ⅰgroup was low(22.18±5.48pg/mL),while those in Ⅱ(37.63±4.52pg/mL), Ⅲ(45.06±4.64pg/mL), Ⅳ(68.89±6.11pg/mL)groups respectively were higher. The IL-17 level inⅠ, Ⅱ, Ⅲ, Ⅳ groups were 4.69±2.03, 6.83±1.02, 9.52±1.30, 10.89±1.26pg/mL respectively. Comparison of IL-23 and IL-17 within four groups revealed: both were increased in Ⅱ group initially, and raised along with the progression of DR. According to the correlation analysis, the expression level of IL-17 of DM was typical positively correlated with IL-23.

CONCLUSION:The over-expression of IL-23 and IL-17 may have a synergistic effect on the occurrence and development, and the IL-23/IL-17 pathway might be associated with the severity of DR by aggravating the inflammatory response of retina. These results indicated that IL-23-IL-17 axis could be a new target for the early diagnosis and treatment of DR.