增生性糖尿病视网膜病变患者玻璃体内血管内皮生长因子的表达

目的 探讨增生性糖尿病视网膜病变(PDR)患者玻璃体内血管内皮生长因子(VEGF)的表达及相关影响因素.方法 病例对照研究.对50例(50只眼)接受玻璃体切除治疗的PDR患者进行分析.术中获取玻璃体标本,并用双抗体夹心酶联免疫吸附试验ELISA法对术中获取的玻璃体标本进行VEGF含量的定量检测,并分析增生性糖尿病视网膜病变患者玻璃体内VEGF的表达情况.平均随访9个月(6～26个月).用成组t检验比较PDR组和正常对照组玻璃体VEGF含量差异,以及硅油填充组与非硅油填充组VEGF含量差异.用方差分析方法比较PDR进展组、稳定组和好转组玻璃体VEGF含量有无差异.用单因素方差分析方法分析玻璃体VEGF含量对PDR术后疗效的影响.结果 PDR组玻璃体VEGF含量平均(592.4801±587.4267)ng/L,正常对照组玻璃体VEGF含量平均(131.3022±26.9192)ng/L.PDR组玻璃体VEGF含量高于对照组(t=3.2315,P＜0.05).术后PDR进展有10只眼(20%),稳定10只眼(20%),好转30只眼(60%).PDR进展组玻璃体VEGF含量显著高于PDR稳定和好转组(q=-3.3187,-4.0843;P＜0.05).术前未接受视网膜光凝组玻璃体VEGF含量显著高于接受全视网膜光凝或局部视网膜光凝组(q=-4.2187,-3.9672;P＜0.05).结论玻璃体VEGF表达与PDR严重程度有一定关系.术后PDR稳定或好转者玻璃体VEGF水平呈相对低表达.(中华眼科杂志,2009,45:206-209)

The expression of vascular endothelial growth factor of vitreous in patients with proliferative diabetic retinopathy

Objective To explore the expression of vascular endothelial growth factor of vitreous in patients with proliferative diabetic retinopathy,and to analyze the relative factors.Methods It was a case control study.Data of 50 eyes of 50 PDR patients who underwent vitrectomy were retrospectively analyzed.The vitreous fluid samples were obtained during surgery.The VEGF level in vitreous fluid was determined by enzyme linked immunosorbent assay,and the expression of vascular endothelial growth factor of vitreous in patients with proliferative diabetic retinopathy wag analyzed.The mean follow-up was 9 months with a range from 6 to 26 months.The VEGF levels in vitreous fluid were compared between PDR patients and normal control,and silicone oil tampenade group and without silicone oil tamponade group by t-test.The changes of VEGF levels in vitreous fluid in eyes with regression,stabilization,and progression were analyzed by analysis of variance.The effects of VEGF levels in vitreous fluid on PDR were analyzed by analysis of variance.Results The mean VEGF level of vitreous was(592.4801±587.4267)ng/L in PDR patients,and it wag(131.3022±26.9192)ug/L in normal control.VEGF level was significantly higher in PDR patients than that in normal control(t=3.2315,P＜0.05).There were 10 eyes(20%)with progression of PDR,10 eyes(20%)with stabilization,and 30 eyes(60%)with regression.Vitreous level of VEGF was significantly higher in eyes with progression of PDR than that in eyes with stabilization or regression of PDR(q=-3.3187,-4.0843:P＜0.05).Vitreous level of VEGF was significantly higher in eyes without retinal photocoagulation than that in eyes underwent panretinal photocoagulation or local photocoagulation(q=-4.2187,-3.9672;P＜0.05).Conclusion There is a correlation between the expression of VEGF of vitreous and the severity of PDR.The expression of VEGF of vitreous presents a relatively lower level in patients with stabilization and regression of PDR.(Chin J Opbthalmol,2009,45:206-209)