应用抗VEGF因子后视网膜增殖膜的病理学观察

发布时间：2018-04-27 10:01

本文选题：糖尿病视网膜病变 + 抗VEGF因子　；参考：《天津医科大学》2010年硕士论文

【摘要】： 目的：观察增殖性糖尿病视网膜病变(proliferative diabetic retinopathy PDR)玻璃体腔注射抗VEGF因子(商品名Avastin)后增殖膜的组织病理学变化,及增殖膜中血管内皮生长因子(vascular endothelia growth factor, VEGF),结缔组织生长因子(connective tissue growth factor,CTGF),色素上皮衍生因子(pigment epitheliumderived factor, PEDF)的表达。方法：选择增殖性糖尿病视网膜病变患者24例(26眼),随机分组,对照组直接行玻璃体切割术,研究组玻璃体腔注射抗VEGF因子(商品名Avastin) 10天后行玻璃体切割术,术中取增殖膜行组织病理学检查,观察糖尿病视网膜增殖膜、新生血管、血管内皮细胞及原始组织细胞的变化,应用免疫组化技术对增殖膜中VEGF, CTGF, PEDF各因子的表达进行观察。结果：光镜下增殖性糖尿病视网膜增殖膜由胶原等细胞外基质以及不同形态细胞构成,大量新生血管散在分布。研究组的新生血管数目,血管内皮细胞和原始组织细胞数目较对照组均有下降,差异有统计学意义(P＜0.05)。 VEGF表达：研究组VEGF阳性表达率较对照组下降,两组间的阳性表达率差异有统计学意义(P＜O.05)。 CTGF表达：多围绕新生血管,尤其在较幼稚的血管周围细胞表达明显,研究组CTGF阳性表达率较对照组上升,两组间的阳性表达率差异有统计学意义(PO.05)。 PEDF阳性染色范围较广泛,分布于胞浆内、胞核内及周围的胶原基质内,研究组PEDF阳性表达率较对照组上升,但差异无统计学意义(P＞0.05)。结论：玻璃体腔注射抗VEGF因子(商品名Avastin)可以抑制新生血管的形成,使视网膜新生血管消退；糖尿病视网膜病变患者玻璃体腔注射抗VEGF因子后视网膜增殖膜增多,CTGF在增殖膜的表达明显增加;PEDF在增殖膜的表达没有明显变化。
[Abstract]:Objective: to observe the histopathological changes of proliferative diabetic retinopathy after intravitreal injection of anti VEGF factor (Avastin) in proliferative diabetic retinopathy. And the expression of vascular endothelial growth factor (endothelia growth factor,), connective tissue growth factor (CTGF), pigment epithelium-derived factor (epitheliumderived factor, PEDF) in proliferative membrane. Methods: Twenty-six eyes of 24 patients with proliferative diabetic retinopathy were randomly divided into two groups. The control group received vitrectomy directly and the study group received vitrectomy 10 days after injection of anti-Avastin factor (commercial name Avastin). The proliferative membrane was taken for histopathological examination, and the changes of proliferating membrane, neovascularization, vascular endothelial cell and primitive histocyte were observed. The expression of VEGF, CTGF, PEDF factors in proliferative membrane was observed by immunohistochemical technique. Results: the proliferative membrane of proliferative diabetic retina was composed of extracellular matrix such as collagen and different morphologic cells under light microscope, and a large number of neovascularization were scattered. The number of neovascularization, endothelial cells and primordial histocytes in the study group were significantly lower than those in the control group (P < 0.05). VEGF expression: the positive expression rate of VEGF in the study group was lower than that in the control group, and the difference between the two groups was statistically significant (P < 0. 05). The expression of CTGF was mainly around neovascularization, especially in the immature perivascular cells. The positive expression rate of CTGF in the study group was higher than that in the control group, and the difference between the two groups was statistically significant. PEDF positive staining was found in the cytoplasm, nucleus and collagen matrix. The positive expression rate of PEDF in the study group was higher than that in the control group, but the difference was not statistically significant (P > 0.05). Conclusion: intravitreal injection of anti VEGF factor (commercial name Avastin) can inhibit the formation of neovascularization and make retinal neovascularization disappear. The expression of VEGF in proliferative membrane was significantly increased in diabetic retinopathy patients after intravitreal injection of anti VEGF factor.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R774.1

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