血清骨膜蛋白、血管内皮生长因子与糖尿病视网膜病变的关系

目的　探讨骨膜蛋白（periostin，PN）与血管内皮生长因子（vascular endothelial growth factor，VEGF）在糖尿病视网膜病变（diabetic retinopathy，DR）患者血清中的变化及其临床意义。方法　收集糖尿病（diabetes mellitus，DM）（病例组53例）患者血清样本，以同期健康体检对象的血清为对照（对照组50名），其中病例组包括无眼底病变的DM患者15例（DM组），NPDR患者18例（NPDR组），PDR患者20例（PDR组），用酶联免疫吸附试验测定各组样本血清中PN、VEGF含量，并分析血清中PN、VEGF与DR的关系。结果　病例组和对照组中PN和VEGF差异均有统计学意义（均为P<0.05）。PN、VEGF在四组间差异均有统计学意义（均为P<0.05）。组间两两比较显示，PN在DM组与NPDR组间比较差异无统计学意义（P＞0.05），在其余组间比较差异均有统计学意义（均为P＜0.05）。VEGF在各组间两两比较差异均有统计学意义（均为P<0.05）。NPDR组和PDR组血清中PN与VEGF均呈正相关（r=0.483、0.509，均为P＜0.05）。结论　血清PN、VEGF参与了DR的发生发展，并与DR后期新生血管及纤维血管膜形成关系密切。

Association of diabetic retinopathy with serum periostin and vascular endothelial growth factor

Objective　To explore the changes in the serum periostin （PN） and vascular endothelial growth factor （VEGF） level in patients with diabetic retinopathy （DR） and the clinical significance.Methods　The serum samples from 53 patients with diabetes mellitus （DM） as case group and 50 healthy subjects as control group were collected and compared in this study.And the DM patients included 15 patients with DM without fundus lesions （DM group），18 patients with non-proliferative diabetic retinopathy （NPDR，NPDR group） and 20 patients with proliferative diabetic retinopathy （PDR，PDR group）.The serum levels of PN and VEGF were analyzed by ELISA assay，and the correlation of DR with serum PN and VEGF levels was evaluated.Results　The differences in serum PN and VEGF between the case group and control group were statistically significant （both P<0.05）.And there were significant difference in PN and VEGF levels among the DM group，NPDR group，PDR group and control group （all P<0.05）.Meanwhile，there was no significant difference in serum PN between the DM group and NPDR group （P>0.05），but there were statistically significant differences among the other groups （all P<0.05）.There were statistically significant differences in serum VEGF among the four groups （all P<0.05）.And finally，positive correlations were found between PN and VEGF in the NPDR group and PDR group（r=0.483，0.509，both P<0.05）.Conclusion　PN and VEGF play an active role in the initiation and development of DR，and they have a close correlation with the neovascularization and fibrovascular membrane of the advanced stage of DR.