视网膜静脉阻塞患者血浆和泪液中血管内皮生长因子表达的研究

目的　观察视网膜静脉阻塞（ｒｅｔｉｎａｌｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＲＶＯ）患者血浆和泪液中血管内皮生长因子（ｖａｓｃｕｌａｒｅｎｄｏｔｈｅｌｉａｌｇｒｏｗｔｈｆａｃｔｏｒ，ＶＥＧＦ）的表达情况。方法　选取我院确诊的２８例ＲＶＯ患者，收集血浆和泪液样本，通过酶联免疫吸附试验测定ＶＥＧＦ表达水平，在１ｄ、２周和４周使用光学相干断层扫描检查中央视网膜厚度（ｃｅｎｔｒａｌｒｅｔｉｎａｌｔｈｉｃｋｎｅｓｓ，ＣＲＴ），另选健康志愿者３０人作为对照组，比较两组血浆和泪液中ＶＥＧＦ、ＣＲＴ表达差异。结果　各时间点，ＲＶＯ组血浆中ＶＥＧＦ表达水平显著高于对照组（均为Ｐ＜０．０５），１ｄＲＶＯ组泪液ＶＥＧＦ表达水平与对照组差异无统计学意义（Ｐ＞０．０５）。ＲＶＯ组血浆和泪液中ＶＥＧＦ表达水平呈微弱正相关（Ｐ＜０．０５），而对照组中这种相关性稍强（Ｐ＜０．０５）。两组２周后ＣＲＴ明显增加，１ｄ与２周ＣＲＴ值差异均有统计学意义（均为Ｐ＜０．０５），２周与４周差异均无统计学意义（均为Ｐ＞０．０５），各时间段ＲＶＯ组与对照组差异有统计学意义（Ｐ＜０．０５）。结论　ＲＶＯ患者泪液中ＶＥＧＦ表达水平及ＣＲＴ与健康人比较显著升高，血浆与泪液中ＶＥＧＦ表达水平的变化有一致性，泪液检测作为非侵入性的检测方式，对ＲＶＯ的早期诊断有较高的临床应用价值。

Expression of VEGF in plasma and tears of patients with RVO

Objective To observe the expression of vascular endothelial growth factor (VEGF) in plasma and tears of patients with retinal vein occlusion ( RVO). Methods Twenty-eight patients with confirmed RVO in our hospital were selected. The plasma and tear samples were collected and the VEGF levels were deternuned by enzyme linked immunosorbent assay. At I day,2 weeks and 4 weeks later.the central retinal thickness ( CRT) was examined by optical coherence tomography. Another 30 cases of healthy volunteers were treated as the control group. The expression of VEGF in plasma and in tears was compared between the two groups. Results At each time point ,the VEGF levels in plasma of RVO patients were significantly higher than those in the control group ( all P < 0. 05 ). At I day, the differences in VEGF levels in tears of RVO patients between the two groups was not statistically significant ( P > 0. 05 ) . The VEGF levels in plasma and tears of patients with RVO were weakly positively correlated ( P < 0. 05 ) .while in the control group , the correlation was more significant ( P < 0. 05 ) . At 2 weeks later, the CRT of the RVO group increased significantly. The differences of CRT values between I day and 2 weeks were significant ( all P < 0. 05 ) ,but there was no statistically significant difference between 2 weeks and 4 weeks ( all P < 0. 05 ). The differences between RVO group and control group at each time point were significant (P < 0. 05) . Conclusion The VEGF levels and CRT in tears of RVO patients are significantly higher than those in healthy patients. Changes of VEGF levels in plasma and tears are consistent. Tear test as a non-intrusive detection method is of higher clinical application value in early diagnosis of RVO.