PFKFB3在PDR患者玻璃体和血清中的表达及其相关性分析

发布时间：2018-05-07 20:21

本文选题：PFKFB3 + VEGF　；参考：《西南医科大学》2017年硕士论文

【摘要】：目的:通过定量检测增殖型糖尿病性视网膜病变(proliferative diabetic retinopathy,PDR)患者玻璃体和血清中磷酸果糖激酶-2/果糖-2,6-二磷酸酶3(phospofructokinase-2/fructose-2,6-bisphosphatase 3,PFKFB3)和血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)的表达水平,并进行相关性分析,探讨PFKFB3在PDR发生发展中可能的作用机制。方法:本研究纳入2015年12月5日至2017年1月19日经门诊诊断为PDR拟行单眼玻璃体切除术的患者42例(A组),其中男24例,女18例,平均年龄55.43±9.29岁,并据患者玻璃体切除术前是否行玻璃体腔注射抗VEGF药物进一步分为非注药组(A1组)和注药组(A2组),其中,A1组16例,男9例,女7例,平均年龄54.88±9.46岁;A2组26例,男15例,女11例,平均年龄55.77±9.35岁。将同期诊断为全层黄斑裂孔(full thickness macular hole,FTMH)及黄斑前膜(preretinal membrane of the macula,PRMM)并符合纳入标准的20例患者作为对照组(B组),其中,男12例,女8例,平均年龄53.95±10.21岁,各组年龄及性别构成比无统计学差异(P=0.054)。所有患者均经睫状体平坦部行25G+微创玻璃体切除术,所有手术均由同一位教授完成。收集各组患者的玻璃体和血清标本,离心取上清,分装后冻存。酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)定量检测玻璃体和血清标本中的PFKFB3和VEGF表达水平,采用SPSS19.0统计学软件对各组数据进行统计学分析。结果:1、A组患者玻璃体中PFKFB3水平(463.17±381.28pg/mL)明显高于B组(158.43±86.88pg/ml)(t=4.919,p0.001),a组血清中pfkfb3水平(153.45±83.78pg/ml)明显高于b组(92.72±32.42pg/ml)(t=4.098,p0.001)。a1组患者玻璃体中pfkfb3水平(797.29±387.44pg/ml)明显高于a2组(257.56±181.49pg/ml)(t=5.230,p0.001),而a1组血清中pfkfb3水平(164.72±102.57pg/ml)与a2组(146.52±71.18pg/ml)差异无统计学意义(t=0.679,p=0.501)。a1、a2和b组患者玻璃体和血清中的pfkfb3水平未见相关性(a1组r=0.194,p=0.471;a2组r=0.071,p=0.731;b组r=0.254,p=0.279)2、a组患者玻璃体中vegf水平(1713.50±1386.90pg/ml)明显高于b组(205.52±92.93pg/ml)(t=7.014,p0.001);a组血清中vegf水平(224.98±168.08pg/ml)明显高于b组(86.80±36.51pg/ml)(t=5.082,p0.001)。a1组患者玻璃体中vegf水平(3399.72±510.06pg/ml)明显高于a2组(675.82±242.57pg/ml)(t=20.014,p0.001),a1组血清中vegf水平(373.40±174.23pg/ml)亦明显高于a2组(133.65±73.10pg/ml)(t=5.228,p0.001)。a1、a2和b组患者玻璃体和血清中的vegf水平均存在正相关关系(a1组r=0.952,p0.001;a2组r=0.423,p=0.031;b组r=0.776,p0.001)。3、a1、a2和b组患者玻璃体中pfkfb3与vegf水平均存在正相关关系(a1组r=0.865,p0.001;a2组r=0.587,p=0.002;b组r=0.807,p0.001),而在血清中仅a2组的pfkfb3与vegf水平存在正相关关系(r=0.444,p=0.023),a1组和b组均无明显相关性(a1组r=-0.130,p=0.631;b组r=0.045,p=0.849)。结论:pdr患者玻璃体和血清中的pfkfb3水平均较对照组患者升高,其可能参与了PDR的发生发展过程;玻璃体腔注射抗VEGF药物后可引起玻璃体及血清中VEGF降低,同时可降低玻璃体腔PFKFB3水平降低,提示VEGF可能通过上调PFKFB3的表达而参与PDR的发生发展,为DR发病机制的进一步研究提供新的理论依据;玻璃体腔注射抗VEGF药物后血清中PFKFB3浓度差异无统计学意义。
[Abstract]:Objective : To investigate the possible mechanism of PFKFB3 in the development of PDR by quantitative detection of the expression level of phosphofructokinase - 2 / fructose - 2,6 - diphosphatase 3 ( PFKFB3 ) and vascular endothelial growth factor ( VEGF ) in patients with proliferative diabetic retinopathy ( PDR ) . Results : The level of vegf in vitreous body and serum of group a1 , a2 and b were significantly higher than that in group B ( 258.43 卤 86.88pg / ml ) ( t = 4.98 , p0.001 ) . The vegf level in the vitreous of group a1 , a2 and b was significantly higher than that in group B ( 75.82 卤 2.57pg / ml ) ( t = 5.071 , p0.001 ) . The vegf level ( 373.40 卤 174.23pg / ml ) in the serum of group a1 was significantly higher than that in group a2 ( 133.65 卤 73.10pg / ml ) ( t = 5.071 , p0.001 ) . There was positive correlation between the vegf levels in the vitreous and serum of a1 , a2 and b groups ( r = 0.952 , p0.001 ; a2 , r = 0.423 , p = 0.031 ; b , r = 0.776 , p = 0.002 ; b , r = 0.807 , p0.001 ) . Conclusion : The expression of VEGF in vitreous and serum of pdr patients is higher than that in the control group , which may be involved in the development of PDR . After injection of anti - VEGF drugs in vitreous cavity , VEGF may be decreased and the level of PFKFB3 in vitreous cavity can be decreased . It is suggested that VEGF may participate in the development of PDR by up - regulating the expression of PFKFB3 , which can provide a new theoretical basis for further study of the pathogenesis of DR . There is no statistical significance in the concentration of PFKFB3 in serum after injection of anti - VEGF drug .

【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R774.1

【参考文献】