不同眼底表现的增生性糖尿病视网膜病变患者玻璃体细胞因子的表达

发布时间：2018-05-09 07:39

本文选题：血管内皮生长因子 + 缺氧诱导因子　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:研究不同眼底表现的增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)患者玻璃体中血管内皮生长因子(ascular endothelial growth factor,VEGF)、缺氧诱导因子-1α(hypoxia-inducible factor-1α,HIF-1α)、结缔组织生长因子(connective tissue growth factor,CTGF)、转化生长因子β2(transforming growth factorβ2,TGF-β2)的表达水平,探讨此四种细胞因子在PDR发展中的差异表达。方法:选取68例因PDR而行玻璃体切除手术患者的玻璃体为实验组(77眼),16例特发性黄斑裂孔(MH)患者玻璃体为对照组(16眼)。实验组分为全视网膜光凝组(PRP组,12眼)和非全视网膜光凝组(NPRP组,65眼)。NPRP组包括视网膜脱离组(15眼)、萎缩膜组(19眼)、血管膜组(17眼)、玻璃体积血组(14眼)。用ELISA法对玻璃体标本进行VEGF、HIF-1α、CTGF、TGF-β2定量检测,并对比分析各组间差别。结果:1.PDR患者玻璃体VEGF、HIF-1α、CTGF、TGF-β2浓度分别为(3064.54±955.41)pg/ml,(0.672±0.204)ng/ml,(6.144±1.382)ng/ml,(3416.45±95.31)pg/ml。MH组玻璃体VEGF、HIF-1α、CTGF、TGF-β2浓度分别为(175.98±49.11)pg/ml,(0.331±0.028)ng/ml,(3.246±0.513)ng/ml,(713.64±182.45)pg/ml。PDR组玻璃体四种细胞因子含量均高于对照组,差异均有统计学意义(P0.05)。2.PRP患者玻璃体VEGF、HIF-1α、CTGF、TGF-β2浓度分别为(1035.76±438.54)pg/ml,(0.420±0.197)ng/ml,(4.109±0.774)ng/ml,(1049.09±158.53)pg/ml。NPRP组玻璃体VEGF、HIF-1α、CTGF、TGF-β2浓度分别为(2157.59±1002.84)pg/ml,(0.578±0.203)ng/ml,(6.611±0.034)ng/ml,(2227.18±962.61)pg/ml。PRP组玻璃体四种细胞因子含量均低于NPRP组,差异均有统计学意义(P0.05)。3.VEGF:视网膜脱离组、萎缩膜组、血管膜组、玻璃体积血组中VEGF表达量分别为(2946.93±1097.16)pg/ml、(1915.74±985.04)pg/ml、(1897.80±842.71)pg/ml、(1573.62±606.33)pg/ml。四组玻璃体中VEGF表达量相比较,视网膜脱离组萎缩膜组=血管膜组玻璃体积血组,除萎缩膜组与血管膜组相比较,差异无统计学意义(P0.05)外,其余各组间相比较,差异均有统计学意义(P0.05)。4.HIF-1α:视网膜脱离组、萎缩膜组、血管膜组、玻璃体积血组中HIF-1α表达量分别为(0.637±0.195)ng/ml、(0.551±0.210)ng/ml、(0.549±0.187)ng/ml、(0.472±0.113)ng/ml。四组玻璃体中HIF-1α表达量相比较,视网膜脱离组萎缩膜组=血管膜组玻璃体积血组,除萎缩膜组与血管膜组相比较,差异无统计学意义(P0.05)外,其余各组间相比较,差异均有统计学意义(P0.05)。5.CTGF:视网膜脱离组、萎缩膜组、血管膜组、玻璃体积血组中CTGF表达量分别为(6.420±0.165)ng/ml、(5.767±0.124)ng/ml、(5.131±0.810)ng/ml、(4.507±0.712)ng/ml。四组玻璃体中CTGF表达量相比较,视网膜脱离组萎缩膜组血管膜组玻璃体积血组,各组间相比较,差异均有统计学意义(P0.05)。6.TGF-β2:视网膜脱离组、萎缩膜组、血管膜组、玻璃体积血组中TGF-β2表达量分别为(3105.29±931.71)pg/ml、(2658.55±873.01)pg/ml、(1918.26±114.58)pg/ml、(1327.18±602.63)pg/ml。四组玻璃体中TGF-β2表达量相比较,视网膜脱离组萎缩膜组血管膜组玻璃体积血组,各组间相比较,差异均有统计学意义(P0.05)。结论:DR发展的不同时期,玻璃体内VEGF、HIF-1α、CTGF、TGF-β2表达有差异,玻璃体中四种细胞因子表达与PDR严重程度有关。
[Abstract]:Objective: To study the vascular endothelial growth factor (ascular endothelial growth factor, VEGF) in the vitreous body of proliferative diabetic retinopathy (PDR) with different fundus manifestations and the hypoxic inducible factor -1 alpha (hypoxia-inducible factor-1 alpha) and connective tissue growth factor (connective tissue growth factor). H factor, CTGF), the expression level of transforming growth factor beta 2 (transforming growth factor beta 2, TGF- beta 2), and to explore the differential expression of the four cytokines in PDR development. Methods: the vitreous body of 68 cases with vitrectomy with PDR was selected as the experimental group (77 eyes), and 16 cases of idiopathic macular hole (MH) patients with vitreous body (16) were used as the control group (16 The experimental group was divided into total retinal photocoagulation group (group PRP, 12 eyes) and non full retinal photocoagulation group (group NPRP, 65 eyes).NPRP group including retinal detachment group (15 eyes), atrophic membrane group (19 eyes), vascular membrane group (17 eyes), vitreous blood group (14 eyes). ELISA method was used to detect VEGF, HIF-1 alpha, CTGF, TGF- beta 2 in vitreous specimens, and compared and analyzed each group. Results: the concentrations of VEGF, HIF-1, CTGF and TGF- beta 2 in the vitreous body of 1.PDR patients were (3064.54 + 955.41) pg/ml, (0.672 + 0.204) ng/ml, (6.144 + 1.382) ng/ml, (3416.45 + 95.31) pg/ml.MH group vitreous VEGF, HIF-1 alpha, and 2 concentration respectively (175.98 + 49.11), respectively. The contents of four kinds of cytokines in the vitreous body of group PDR were higher than those in the control group. The differences were statistically significant (P0.05) in the vitreous VEGF, HIF-1 a, CTGF, TGF- beta 2, respectively (1035.76 + 438.54) pg/ml, (0.420 + 0.197) ng/ml, (4.109 + 0.774) ng/ml, (1049.09 + 158.53) pg/ml.NPRP group vitreous VEGF, 2 concentration (215), respectively (215) 7.59 + 1002.84) pg/ml, (0.578 + 0.203) ng/ml, (6.611 + 0.034) ng/ml, (2227.18 + 962.61) pg/ml.PRP group of vitreous body four kinds of cytokines were lower than the NPRP group, the difference was statistically significant (P0.05).3.VEGF: retinal detachment group, atrophic membrane group, vascular membrane group, vitreous blood group VEGF expression of (2946.93 + 1097.16) pg/ml, respectively (1915.). 74 + 985.04) pg/ml, (1897.80 + 842.71) pg/ml, (1573.62 + 606.33) pg/ml. four vitreous body VEGF expression phase comparison, retinal detachment group atrophy membrane group = vitreous blood group of vascular membrane group, except for the atrophy membrane group and the vascular group, the difference was not statistically significant (P0.05), the other groups were compared, the difference was statistically significant (P0.05 .4.HIF-1 alpha: the expression of HIF-1 alpha in the retinal detachment group, the atrophy membrane group, the vascular membrane group and the vitreous blood group were (0.637 + 0.195) ng/ml, (0.551 + 0.210) ng/ml, (0.549 + 0.187) ng/ml, and (0.472 + 0.113) ng/ml. four groups in the vitreous body, compared with the atrophy of the retinal detachment group = the vitreous blood group of the vascular membrane group, except for atrophy. The difference of the membrane group and the vascular group was not statistically significant (P0.05), and the differences were statistically significant (P0.05).5.CTGF: retinal detachment group, atrophic membrane group, vascular membrane group, and vitreous blood group, CTGF expression was (6.420 + 0.165) ng/ml, (5.767 + 0.124) ng/ml, (5.131 + 0.810) ng/ml, (4.507 + 0.712) ng/m The expression of CTGF in the vitreous body of L. four groups was compared. The difference in the vitreous blood group of the retinal detachment group was statistically significant (P0.05) in the.6.TGF- beta 2: retinal detachment group, the expression of TGF- beta 2 in the atrophic membrane group, the vascular membrane group and the vitreous blood group was (3105.29 + 931.71) pg/ml, respectively, (2658.55 + 873.01). Pg/ml, (1918.26 + 114.58) pg/ml, (1327.18 + 602.63) pg/ml. four groups of vitreous TGF- beta 2 expression phase comparison, retinal detachment group atrophy membrane group Glass Group vitreous blood group, the difference is statistically significant (P0.05). Conclusion: there are differences in the expression of VEGF, HIF-1 a, CTGF, TGF- beta 2 in the different stages of the development of DR. The expression of four cytokines in vitreous body is related to the severity of PDR.

【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R774.1

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