视网膜脱离复位术前后血浆及视网膜下液的检测

目的探讨视网膜脱离手术前后血浆及视网膜下液（ｓｕｂｒｅｔｉｎａｌｆｌｕｉｄ，ＳＲＦ）中人表皮生长因子（ｈｕｍａｎｅｐｉｔｈｅｌｉａｌｇｒｏｗｔｈｆａｃｔｏｒ，ｈ－ＥＧＦ）、肿瘤坏死困子（ｔｕｍｏｒｎｅｃｒｏｓｉｓｆａｃｔｏｒ，ＴＮＦ）含量与增殖性玻璃体视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｖｉｔｒｅｏｒｅｔｉｎｏｐａｔｈｙ，ＰＶＲ）形成的关系。方法采集５１例视网膜脱离伴ＰＶＲ者手术前、后血浆及ＳＲＦ，采用放射免疫方法测定其中ｈ－ＥＧＦ及ＴＮＦ含量。结果ＰＶＲ患者血浆ｈ－ＥＧｐ、ＴＮＦ值较正常人升高，但差异无显著性；与病怀轻重程度无关。ＳＲＦ中ｈ－ＥＧＦ、ＴＮＦ含量随病情加重而升高；ＳＲＦ中ｈ－ＥＧＦ与ＴＮＦ浓度呈正相关（Ｐ＜０．０５）。视网膜脱离复位术后５天，血浆中ｈ－ＥＧＦ、ＴＮＦ显著升高（Ｐ＜０．０１），术后１５、３０天二者浓度下降，但未降至正常。结论ＳＲＦ中ｈ－ＥＧＦ、ＴＮＦ二者有助同作用，并与ＰＶＲ的发生和发展有密切关系；血浆中一定浓度的ｈ－ＥＧＦ、ＴＮＦ参与视网膜脱离复位术中的创伤修复与炎症反应，但高浓度则影响手术效果。

Measurements of serum and subretinal fluid before and after surgery of retinal detachment]

OBJECTIVES: To investigate the relationships between proliferative vitreoretinopathy (PVR) formation and the levels of human epidermal growth factor (h-EGF) and tumor necrosis factor (TNF) in serum and subretinal fluid (SRF) before and after surgery of retinal detachment with PVR. METHODS: Serum and SRF samples of 51 patients with retinal detachment and PVR were collected, and their h-EGF and TNF levels were measured by radioimmunoassays. RESULTS: In comparison with the control group, the levels of h-EGF and TNF in serum and SRF in retinal detachment with PVR group were higher but not statistically significant (P > 0.05). Their levels in the serum were not related to the severity of the disease, while their levels in SRF increased significantly with the increase of the severity of the disease, and these two factors were positively correlated (P < 0.05). 5 days after the surgery of retinal detachment, the h-EGF and TNF levels in serum increased significantly (P < 0.01) and the levels decreased within 30 days but not to normal. CONCLUSIONS: The h-EGF and TNF in SRF might have a synergic action and affect the formation and development of PVR. The h-EGF and TNF in serum take part in the repair of the operative trauma and inflammatory reaction. However, their high levels could interfere with the effect of operation.