Conbercept对增殖型糖尿病视网膜病变眼内PIGF的影响
发布时间：2018-08-31 12:56
【摘要】：目的:测定增殖型糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)患者房水及玻璃体液中血管内皮生长因子(vascular endothelial growth factor,VEGF)和胎盘生长因子(placenta growth factor,Pl GF)浓度及玻璃体腔康柏西普(intravitreal Conbercept,IVC)注射后房水及玻璃体液中VEGF和Pl GF浓度变化以及两种细胞因子之间的相关性。进一步探讨Pl GF在PDR发病机制中的作用,为防治PDR病变提供理论依据。方法:收集2015年12月至2016年12月就诊于我院的25例患者纳入研究,实验组为PDR患者16例,分为A(8例9眼)、B(8例9眼)两组。A组行IVC注射联合玻璃体切割术,分别在IVC注射前收集房水,在IVC注射7天后行玻璃体切割术中收集房水及玻璃体液。B组行单纯玻璃体切割术,在术中收集房水及玻璃体液。对照组(9例9眼)为孔源性视网膜脱离需要行玻璃体切割术的非糖尿病患者,在术中收集房水及玻璃体液。通过酶联免疫吸附测定法(enzyme-linked immunosorbent assay,ELISA)检测房水及玻璃体液中VEGF和Pl GF浓度。监测各组术后1周、1月及3月的最佳矫正视力(best corrected visual acuity,BCVA)以及实验组术后3月黄斑中心凹厚度(central macular thickness,CMT)。结果:1、实验组A IVC注药前房水中VEGF和Pl GF平均浓度分别为(269.255±118.1),(355.464±204.875)pg/ml;IVC注药后房水平均浓度分别为(128.712±60.692),(219.622±151.487)pg/ml;实验组B房水中VEGF和Pl GF平均浓度分别为(301.0291±173.582),(478.733±273.873)pg/ml;对照组房水中VEGF和Pl GF平均浓度分别为(11.751±5.53),(12.363±7.279)pg/ml。实验组A IVC注药前和实验组B房水中VEGF与Pl GF浓度显著高于对照组(Z=-3.578,P0.05);注药前后房水中VEGF与Pl GF浓度具有显著差异(Z=-2.666,P0.05);实验组A IVC注药前与实验组B房水中VEGF、Pl GF浓度均无显著差异(Z=-0.221,-0.927,P0.05)。2、实验组B玻璃体中VEGF和Pl GF平均浓度分别为(911.804±330.925),(763.774±373.526)pg/ml;对照组玻璃体中VEGF和Pl GF平均浓度分别为(41.964±10.115),(40.742±20.27)pg/ml。实验组B与对照组玻璃体中VEGF、Pl GF浓度比较均具有显著差异(Z=-3.584,-3.578,P0.05)。3、实验组A IVC注药前(r=0.683,P0.05)与注药后(r=0.800,P0.05)以及实验组B(r=0.700,P0.05)房水VEGF和Pl GF浓度均有正相关关系;对照组房水VEGF和Pl GF浓度无显著相关性(r=0.075,P0.05)。4、实验组A IVC注药后(r=0.567,P0.05)与对照组(r=0.375,P0.05)玻璃体VEGF和Pl GF浓度无显著相关性;实验组B玻璃体VEGF和Pl GF浓度之间有正相关关系(r=0.867,P0.05)。5、实验组A IVC注药后房水与玻璃体中VEGF浓度有正相关关系(r=0.800,P0.05),Pl GF浓度有正相关关系(r=0.833,P0.05);实验组B房水与玻璃体中VEGF浓度有正相关关系(r=0.717,P0.05),Pl GF浓度有正相关关系(r=0.800,P0.05);对照组房水与玻璃体中VEGF浓度无显著相关性(r=0.519,P0.05),Pl GF浓度无显著相关性(r=0.435,P0.05)。6、术后3月平均log MAR BCVA实验组A为0.743±0.487;实验组B为1.147±0.95;对照组为0.48±0.199。三组与术前BCVA对比均有所提高(t=9.463,P0.05)但实验组A与B术后3月log MAR BCVA之间无显著差异(t=-1.134,P0.05);实验组A与实验组B术后3月平均CMT分别为267.778±120.695μm(范围:152~548μm)410.889±213.542μm(范围:179~769μm),两组之间无显著差异(Z=-1.546,P0.05)。结论:1、PDR患者房水及玻璃体液高浓度VEGF及Pl GF可能与眼内新生血管发生、发展密切相关。2、经IVC注射治疗后房水及玻璃体中VEGF和Pl GF浓度均有所下降,表明Conbercept对VEGF和Pl GF有较好的抑制作用。3、PDR患者房水及玻璃体中Pl GF浓度与VEGF浓度显著的相关,表明两种细胞因子之间可能存在相互调节作用,并且细胞因子的产生主要在视网膜局部。4、PDR患者经IVC注射联合23G微创玻璃体切割术,可以提高术后视力,但术后视力改善与是否行IVC治疗无明显关系,术后视力提高与CMT呈负相关。
[Abstract]:AIM: To determine the concentrations of vascular endothelial growth factor (VEGF) and placenta growth factor (Pl GF) in aqueous humor and vitreous humor of patients with proliferative diabetic retinopathy (PDR) and intravitreal Conbercept (IVC) in vitreous cavity. To explore the role of Pl GF in the pathogenesis of PDR and provide theoretical basis for the prevention and treatment of PDR. Methods: 25 patients with PDR from December 2015 to December 2016 were enrolled in the study. In group A, aqueous humor was collected before IVC injection and 7 days after IVC injection. In group B, aqueous humor and vitreous humor were collected during vitrectomy. In group B, aqueous humor and vitreous humor were collected during vitrectomy. In group B, aqueous humor and vitreous humor were collected during vitrectomy. The concentrations of VEGF and PLGF in aqueous humor and vitreous humor were measured by enzyme-linked immunosorbent assay (ELISA). The best corrected visual acuity (BCVA) was monitored one week, one month and three months after vitrectomy in each group. Results: 1. The average concentrations of VEGF and PLGF in aqueous humor before IVC injection in experimental group were (269.255+118.1), (355.464+204.875) pg/ml, and (128.712+60.692), (219.622+151.487) pg/ml in aqueous humor of experimental group B, respectively. The average concentrations of VEGF and Pl GF in the aqueous humor of the control group were (11.751+5.53), (12.363+7.279) pg/ml, respectively. The concentrations of VEGF and Pl GF in the aqueous humor of the experimental group and the experimental group were significantly higher than those in the control group (Z=-3.578, P 0.05). There was significant difference (Z = - 2.666, P 0.05); there was no significant difference in the concentrations of VEGF and Pl GF between the experimental group and the experimental group (Z = - 0.221, - 0.927, P 0.05). The average concentrations of VEGF and Pl GF in the experimental group B vitreous body were (911.804 [330.925], (763.774 [373.526] pg / ml; the average concentrations of VEGF and Pl GF in the control group B vitreous body were (41.964 [1.924]] pg / ml, respectively. There were significant differences in the concentrations of VEGF and Pl GF between experimental group B and control group (Z = - 3.584, - 3.578, P 0.05). 3. There were positive correlations between the concentrations of VEGF and Pl GF in aqueous humor of experimental group A IVC before injection (r = 0.683, P 0.05) and after injection (r = 0.800, P 0.05) as well as experimental group B (r = 0.700, P 0.05). There was no significant correlation between the concentration of F (r = 0.075, P 0.05). There was no significant correlation between the concentration of VEGF and PLGF in the vitreous body of the experimental group (r = 0.567, P 0.05) and the control group (r = 0.375, P 0.05); there was a positive correlation between the concentration of VEGF and PLGF in the vitreous body of the experimental group (r = 0.867, P 0.05). There was a positive correlation between the concentration of Pl GF (r = 0.800, P 0.05) and the concentration of Pl GF (r = 0.833, P 0.05); there was a positive correlation between the concentration of VEGF and aqueous humor (r = 0.717, P 0.05), and a positive correlation between the concentration of Pl GF (r = 0.800, P 0.05); there was no significant correlation between aqueous humor and the concentration of VEGF (r = 0.519, P 0.05) in the control group, but no significant correlation between the concentration of Pl GF (r = 0.435, P 0.435, P 0.05). The mean log MAR BCVA in experimental group A was 0.743 (+ 0.487) at 3 months postoperatively, 1.147 (+ 0.95) in experimental group B, and 0.48 (+ 0.199) in control group. Compared with preoperative BCVA, the mean log MAR BCVA in experimental group A was higher (t = 9.463, P 0.05), but there was no significant difference between experimental group A and B at 3 months postoperatively (t = - 1.134, P 0.05). There was no significant difference between the two groups (Z = - 1.546, P 0.05). Conclusion: 1. High concentrations of VEGF and Pl GF in aqueous humor and vitreous humor of patients with PDR may be closely related to the occurrence and development of intraocular neovascularization. The decrease indicated that Conbercept had a better inhibitory effect on VEGF and PLGF. 3. There was a significant correlation between the concentration of Pl GF in aqueous humor and vitreous body of patients with PDR and the concentration of VEGF, suggesting that there might be an interaction between the two cytokines, and the production of cytokines was mainly localized in the retina. 4. PDR patients were injected with IVC combined with 23G minimally invasive vitreous body. Incision can improve postoperative visual acuity, but the improvement of postoperative visual acuity has no significant relationship with IVC treatment. Postoperative visual acuity is negatively correlated with CMT.
【学位授予单位】：西安医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R774.1
本文编号：2215051
[Abstract]:AIM: To determine the concentrations of vascular endothelial growth factor (VEGF) and placenta growth factor (Pl GF) in aqueous humor and vitreous humor of patients with proliferative diabetic retinopathy (PDR) and intravitreal Conbercept (IVC) in vitreous cavity. To explore the role of Pl GF in the pathogenesis of PDR and provide theoretical basis for the prevention and treatment of PDR. Methods: 25 patients with PDR from December 2015 to December 2016 were enrolled in the study. In group A, aqueous humor was collected before IVC injection and 7 days after IVC injection. In group B, aqueous humor and vitreous humor were collected during vitrectomy. In group B, aqueous humor and vitreous humor were collected during vitrectomy. In group B, aqueous humor and vitreous humor were collected during vitrectomy. The concentrations of VEGF and PLGF in aqueous humor and vitreous humor were measured by enzyme-linked immunosorbent assay (ELISA). The best corrected visual acuity (BCVA) was monitored one week, one month and three months after vitrectomy in each group. Results: 1. The average concentrations of VEGF and PLGF in aqueous humor before IVC injection in experimental group were (269.255+118.1), (355.464+204.875) pg/ml, and (128.712+60.692), (219.622+151.487) pg/ml in aqueous humor of experimental group B, respectively. The average concentrations of VEGF and Pl GF in the aqueous humor of the control group were (11.751+5.53), (12.363+7.279) pg/ml, respectively. The concentrations of VEGF and Pl GF in the aqueous humor of the experimental group and the experimental group were significantly higher than those in the control group (Z=-3.578, P 0.05). There was significant difference (Z = - 2.666, P 0.05); there was no significant difference in the concentrations of VEGF and Pl GF between the experimental group and the experimental group (Z = - 0.221, - 0.927, P 0.05). The average concentrations of VEGF and Pl GF in the experimental group B vitreous body were (911.804 [330.925], (763.774 [373.526] pg / ml; the average concentrations of VEGF and Pl GF in the control group B vitreous body were (41.964 [1.924]] pg / ml, respectively. There were significant differences in the concentrations of VEGF and Pl GF between experimental group B and control group (Z = - 3.584, - 3.578, P 0.05). 3. There were positive correlations between the concentrations of VEGF and Pl GF in aqueous humor of experimental group A IVC before injection (r = 0.683, P 0.05) and after injection (r = 0.800, P 0.05) as well as experimental group B (r = 0.700, P 0.05). There was no significant correlation between the concentration of F (r = 0.075, P 0.05). There was no significant correlation between the concentration of VEGF and PLGF in the vitreous body of the experimental group (r = 0.567, P 0.05) and the control group (r = 0.375, P 0.05); there was a positive correlation between the concentration of VEGF and PLGF in the vitreous body of the experimental group (r = 0.867, P 0.05). There was a positive correlation between the concentration of Pl GF (r = 0.800, P 0.05) and the concentration of Pl GF (r = 0.833, P 0.05); there was a positive correlation between the concentration of VEGF and aqueous humor (r = 0.717, P 0.05), and a positive correlation between the concentration of Pl GF (r = 0.800, P 0.05); there was no significant correlation between aqueous humor and the concentration of VEGF (r = 0.519, P 0.05) in the control group, but no significant correlation between the concentration of Pl GF (r = 0.435, P 0.435, P 0.05). The mean log MAR BCVA in experimental group A was 0.743 (+ 0.487) at 3 months postoperatively, 1.147 (+ 0.95) in experimental group B, and 0.48 (+ 0.199) in control group. Compared with preoperative BCVA, the mean log MAR BCVA in experimental group A was higher (t = 9.463, P 0.05), but there was no significant difference between experimental group A and B at 3 months postoperatively (t = - 1.134, P 0.05). There was no significant difference between the two groups (Z = - 1.546, P 0.05). Conclusion: 1. High concentrations of VEGF and Pl GF in aqueous humor and vitreous humor of patients with PDR may be closely related to the occurrence and development of intraocular neovascularization. The decrease indicated that Conbercept had a better inhibitory effect on VEGF and PLGF. 3. There was a significant correlation between the concentration of Pl GF in aqueous humor and vitreous body of patients with PDR and the concentration of VEGF, suggesting that there might be an interaction between the two cytokines, and the production of cytokines was mainly localized in the retina. 4. PDR patients were injected with IVC combined with 23G minimally invasive vitreous body. Incision can improve postoperative visual acuity, but the improvement of postoperative visual acuity has no significant relationship with IVC treatment. Postoperative visual acuity is negatively correlated with CMT.
【学位授予单位】：西安医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R774.1
【参考文献】
相关期刊论文 前1条
1 易伟华,魏锐利,蔡季平,李玉莉;血管内皮生长因子和转化生长因子β_1在眼眶海绵状血管瘤的表达及意义[J];国际眼科杂志;2004年02期
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