Abstract：
OBJECTIVE: To compare the levels of endocannabinoids (EC) in plasma, aqueous humor and tears, cortisol in plasma and aqueous, in primary angle closure glaucoma (PACG) and controls, while comparing the quality of life in both groups.
METHODS: A total of 60 patients, ≥40years of age, with a diagnosis of PACG or cataract, 30 in each group were recruited. They were subjected to a detailed ophthalmic evaluation, a WHO Quality of Life Brief Version (WHOQOL-BREF) questionnaire answering and collection of tear, aqueous and blood samples. The levels of endocannabinoids-anandamide (AEA), 2-arachidonoylglycerol (2AG) in plasma, aqueous humor and tears; cortisol in plasma and aqueous humor; and WHO-QOL score in each group were noted.
RESULTS: Plasma AEA (p = 0.01) and plasma 2-AG, (p = 0.002) levels were significantly higher in the control group as compared to the PACG group. WHO-QOL score was better in controls (p < 0.001). The EC were in undetectable levels in aqueous. Plasma and aqueous cortisol were significantly higher in PACG and both had the highest Area under the receiver operating characteristics (AUROC) curve value for differentiating PACG from controls. Tear 2AG and tear AEA had a moderately strong positive correlation with plasma 2-AG. Females had insignificantly higher levels of plasma and tear endocannabinoids.
CONCLUSIONS: Tear endocannabinoids were determined for the first time in PACG and normal with no difference between the two groups. Plasma and aqueous cortisol levels are a differentiating factor between normal and glaucoma patients with plasma endocannabinoids being remarkably higher in normals. Quality of life in glaucoma patients with high cortisol levels is poorer.
METHODS: A total of 60 patients, ≥40years of age, with a diagnosis of PACG or cataract, 30 in each group were recruited. They were subjected to a detailed ophthalmic evaluation, a WHO Quality of Life Brief Version (WHOQOL-BREF) questionnaire answering and collection of tear, aqueous and blood samples. The levels of endocannabinoids-anandamide (AEA), 2-arachidonoylglycerol (2AG) in plasma, aqueous humor and tears; cortisol in plasma and aqueous humor; and WHO-QOL score in each group were noted.
RESULTS: Plasma AEA (p = 0.01) and plasma 2-AG, (p = 0.002) levels were significantly higher in the control group as compared to the PACG group. WHO-QOL score was better in controls (p < 0.001). The EC were in undetectable levels in aqueous. Plasma and aqueous cortisol were significantly higher in PACG and both had the highest Area under the receiver operating characteristics (AUROC) curve value for differentiating PACG from controls. Tear 2AG and tear AEA had a moderately strong positive correlation with plasma 2-AG. Females had insignificantly higher levels of plasma and tear endocannabinoids.
CONCLUSIONS: Tear endocannabinoids were determined for the first time in PACG and normal with no difference between the two groups. Plasma and aqueous cortisol levels are a differentiating factor between normal and glaucoma patients with plasma endocannabinoids being remarkably higher in normals. Quality of life in glaucoma patients with high cortisol levels is poorer.
摘要：
目的：比较血浆中内源性大麻素（EC）的水平，房水和眼泪，血浆和水溶液中的皮质醇，原发性闭角型青光眼（PACG）和对照，同时比较两组的生活质量。
方法：共60例患者，≥40岁，诊断为PACG或白内障，每组招募30人。他们接受了详细的眼科评估，世界卫生组织生活质量简报版(WHOQOL-BREF)问卷，回答和收集眼泪，水和血液样本。内源性大麻素-anandamide（AEA）的水平，血浆中的2-花生四酰基甘油（2AG），记录各组的房水和泪液;血浆和房水中的皮质醇;以及WHO-QOL评分.
结果：血浆AEA（p=0.01）和血浆2-AG，与PACG组相比，对照组的水平（p=0.002）明显更高。对照组WHO-QOL评分较好(p<0.001)。EC在水溶液中处于不可检测的水平。PACG中的血浆和水性皮质醇均显着较高，并且在区分PACG与对照组的接受者工作特征（AUROC）曲线值下都具有最高的面积。泪液2AG和泪液AEA与血浆2-AG呈中度正相关。女性的血浆和泪液内源性大麻素水平明显较高。
结论：首次在PACG和正常人中测定了撕裂内源性大麻素，两组之间没有差异。血浆和水性皮质醇水平是正常和青光眼患者之间的区别因素，正常人血浆内源性大麻素明显更高。皮质醇水平高的青光眼患者的生活质量较差。
方法：共60例患者，≥40岁，诊断为PACG或白内障，每组招募30人。他们接受了详细的眼科评估，世界卫生组织生活质量简报版(WHOQOL-BREF)问卷，回答和收集眼泪，水和血液样本。内源性大麻素-anandamide（AEA）的水平，血浆中的2-花生四酰基甘油（2AG），记录各组的房水和泪液;血浆和房水中的皮质醇;以及WHO-QOL评分.
结果：血浆AEA（p=0.01）和血浆2-AG，与PACG组相比，对照组的水平（p=0.002）明显更高。对照组WHO-QOL评分较好(p<0.001)。EC在水溶液中处于不可检测的水平。PACG中的血浆和水性皮质醇均显着较高，并且在区分PACG与对照组的接受者工作特征（AUROC）曲线值下都具有最高的面积。泪液2AG和泪液AEA与血浆2-AG呈中度正相关。女性的血浆和泪液内源性大麻素水平明显较高。
结论：首次在PACG和正常人中测定了撕裂内源性大麻素，两组之间没有差异。血浆和水性皮质醇水平是正常和青光眼患者之间的区别因素，正常人血浆内源性大麻素明显更高。皮质醇水平高的青光眼患者的生活质量较差。
