渗出性年龄相关性黄斑变性患者玻璃体液中VEGF的改变及与炎症的关系

目的：研究血管内皮生长因子(vascular endothelial growth factor，VEGF)在渗出性年龄相关性黄斑变性(age-related macular degeneration，ARMD)患者玻璃体液中的改变及与炎症的关系。

方法：纳入2016-09/2017-09于我院就诊的渗出性ARMD患者61例61眼作为观察组，另纳入特发性黄斑裂孔(idiopathic macular hole，IMH)患者25例25眼作为对照组。抽取两组患者玻璃体液0.5mL，检测VEGF、白介素-10(IL-10)及白介素-6(IL-6)的水平，并分析VEGF与炎症介质的关系。

结果：观察组患者玻璃体液内VEGF及IL-6水平均显著高于对照组患者(t=32.530、8.443，均P<0.01)。两组患者玻璃体液IL-10水平比较，差异无统计学意义(P>0.05)。ROC曲线分析显示，以460.6pg/mL为截点值，VEGF鉴别ARMD和IMH的敏感性为84.00%，特异性为93.44%，曲线下面积为0.879，优于IL-6。观察组患者玻璃体液VEGF水平与IL-6呈显著正相关关系(r=0.787，P<0.01)。

结论：渗出性ARMD患者玻璃体内VEGF水平显著升高，并与炎症呈正相关，且VEGF水平对于鉴别IMH有一定价值。

Expression of VEGF in vitreous humor of patients with age-related macular degeneration and its relationship with inflammation

AIM:To analyze the expression of vascular endothelial growth factor(VEGF)in vitreous humor of patients with age-related macular degeneration(ARMD)and its relationship with inflammation.

METHODS:Clinical data of 61 patients with ARMD(61 eyes)received treatment at our hospital from September 2016 to September 2017 were analyzed as Group A. And 25 idiopathic macular hole(IMH)patients(25 eyes)were enrolled as Group B. VEGF, IL-6 and IL-10 levels in vitreous humor were tested and compared between the two group.

RESULTS: Group A patients had higher levels of VEGF and IL-6 in vitreous humor than these of Group B patients, the difference were statistically significant(t=32.530, 8.443; P<0.01). The level of IL-10 between the two groups was not significantly different(P>0.05). ROC analysis showed that the VEGF cut-off point value of 460.6pg/mL, as used for the differential diagnosis between ARMD and IMH, provided a sensitivity of 84.00%, a specificity of 93.44%, area under the curve(AUC)was 0.879, better than these of IL-6. Correlation analysis showed that, for Group A patients, the levels of VEGF had significant positive correlation with IL-6(r=0.787, P<0.01).

CONCLUSION: The level of VEGF increased significantly in patients with ARMD and had positive correlation with inflammation, which can be used as an auxiliary diagnosis marker for ARMD from IMH.