增生性玻璃体视网膜病变玻璃体中的Ⅲ型前胶原

目的:检测增生性玻璃体视网膜病变(PVR)患者血清及玻璃体中Ⅲ型前胶原(Procollagen Ⅲ,PC Ⅲ)的含量,探讨其在PVR发病中的作用。方法:用放射免疫测定法测定5例正常人玻璃体,20例正常人血清及29例孔源性视网膜脱离合并PVR患者玻璃体及血清中的PC Ⅲ。用Logistic回归模型分析PVR患者发病时间、手术史、增生膜及PVR分级与PC Ⅲ含量的相关性。结果:PVR患者血清和对照组血清PC Ⅲ含量分别为83.76±18.52和85.02±17.50μg/L(P>0.05)。正常对照玻璃体PC Ⅲ含量低于最小可测值(40 μg/L)。PVR患者组中有12例未检测到,其余17例玻璃体中PC Ⅲ含量明显升高,平均268.69±176.07μg/L(P<0.05)。玻璃体PC Ⅲ水平与病史长短和PVR级别相关,发病时间延长,其玻璃体PC Ⅲ含量大于40μg/L的概率是小于40 μg/L的5.2655倍;PVR级别增加,其玻璃体PC Ⅲ含量大于40 μg/L的概率是小于40 μg/L的2.7978倍。结论:多数PVR患者玻璃体内可测得PC Ⅲ含量增加,并与PVR分级及发病时间长短相关。PC Ⅲ合成活跃属眼内的局部反应。提示PC Ⅲ及Ⅲ型胶原在PVR发展中起一定的作用。眼科学报1998;14:76—79。

Precollagen III in the Vitreous of Eyes with Proliferative Vitreoretinopathy

PURPOSE: To detect precollagen III (PC III) levels in serum and vitreous samples from patients with proliferative vitreoretinopathy (PVR). METHODS: PC III levels were measured by radioimmunoassay in 5 cadaveric vitreous samples from normal subjects, 20 normal human serum samples, 29 vitreous and serum samples from patients with rhegmatogenous retinal detachment complicated with PVR. The relationship between PC III levels and PVR history, surgery, epiretinal membrane, severity of PVR were analyzed with Logistic regression analysis. RESULTS: The mean PC III levels in serum samples of PVR patients and control subjects were 83.76 +/- 18.52 and 85.02 +/- 17.50 micrograms/L respectively (P > 0.05). PC III was not detected (< 40 micrograms/L) in the cadaveric vitreous. In vitreous aspirates from 29 eyes with PVR, it was not detected in 12 eyes, but higher than 40 micrograms/L in 17 eyes with the mean level of 268.69 +/- 176.07 micrograms/L. (P < 0.05) The high levels correlated with duration and severity of PVR. As onset time and PVR grade increasing, the probability of PC III concentration higher than 40 micrograms/L was 5.2655 and 2.7978 times the concentration lower than 40 micrograms/L respectively. CONCLUSION: PC III can be detected in vitreous aspirates from PVR eyes. The PC III levels in the vitreous was an event of local responses and were correlated with severity and history of PVR. This suggests that PC III and collagen III be involved in the development of PVR.