增生型糖尿病视网膜病变患者玻璃体内注射贝伐单抗后房水中细胞因子的变化及其相关性分析

目的 研究增生型糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)患者玻璃体内注射贝伐单抗(intravitreal bevacizumab,IVB)后房水中细胞因子的变化情况及其相关性.方法 收集2014年4月至2015年2月在我院行玻璃体切割(pars plana vitrectomy,PPV)术联合术前3～7d给予IVB辅助治疗的严重PDR患者56例(63眼),分别于IVB及PPV术时收集两次房水,采用Cytometric Bead Array (CBA)方法测量房水中血管内皮生长因子(vascular endothelial growth factor,VEGF)、白细胞介素6(interleukin-6,IL-6)、白细胞介素8(interleukin-8,IL-8)及单核细胞趋化因子-1(monocyte chemotactic protein-1,MCP-1)的浓度;分析IVB后房水中细胞因子浓度变化及各细胞因子的相关性.结果 IVB后3～7d,房水中VEGF浓度为(6.57±12.29)pg·mL-1,较术前(278.71±340.20)pg·mL-降低,差异具有统计学意义(P ＜0.05);IL-8浓度为(385.60±1099.47) pg·mL-1,较术前(298.87±1005.79)pg·mL-1升高,差异具有统计学意义(P ＜0.05);IL-6及MCP-1浓度均高于术前,但差异均无统计学意义(均为P＞0.05).VEGF、IL-6、IL-8及MCP-1各细胞因子两两之间均存在明显的相关性(均为P＜0.05).结论 PDR患者新生血管的生成过程可能是由多种细胞因子调节,针对性降低VEGF浓度可以代偿性引起其他细胞因子浓度的升高.

Changes of cytokines in aqueous humor of patients with proliferative diabetic retinopathy after intravitreal bevacizumab and their correlation analysis

Objective To study the changes of cytokines in aqueous humor of patients with proliferative diabetic retinopathy (PDR)after intravitreal bevacizumab (IVB) and the correlation of these cytokines.Methods Fifty-six patients(63 eyes) with severe PDR underwent pars piana vitrectomy (PPV) with IVB pretreatment in our hospital from April,2014 to February,2015 were collected.All the patients received IVB therapy from 3 days to 7 days before PPV.Aqueous humor samples were collected at the time of IVB and PPV treatment.The concentrations of vascular endothelial growth factor (VEGF),interleukin-6 (IL-6),interleukin-8 (IL-8) and monocyte chemotactic protein-1 (MCP-1) were measured by cytoinetric bead array (CBA).The changes of these cyto-kines after IVB were analyzed by using Wilcoxon rank sum test for paired data.The correlation between these cytokines was analyzed by using Spearman rank test.Results From 3 days to 7 days after IVB,the concentration of VEGF in aqueous humor was (6.57 ± 12.29)pg · mL-1,lower than the pre-operation of (278.71 ±340.20)pg · mL-1,the difference was statistically significant (P ＜ 0.05).The concentration of IL-8 was (385.60 ± 1099.47) pg · mL-1,higher than pre-operation of(298.87 ± 1005.79) pg ·mL-1,the difference was statistically significant (P ＜ 0.05).IL-6 and MCP-1 were increased after IVB,but the difference was not statistically significant (all P ＞ 0.05).VEGF,IL-6,IL-8 and MCP-1 had an obviously relationship between each two factors(all P ＜ 0.05).Conclusion Angiogenesis in patients with PDR are regulated by a variety of cytokines,and targeted reduction of VEGF may compensatory increase the concentration of other inflammatory cytokines.