血清及房水中VEGF、IL-6水平与新生血管性青光眼的相关性研究

发布时间：2018-05-17 05:24

本文选题：新生血管性青光眼 + 血管内皮生长因子　；参考：《大连医科大学》2011年硕士论文

【摘要】：目的:新生血管性青光眼(neovascular glaucoma, NVG)是一种病因复杂、临床表现严重的难治性、顽固性青光眼,是一种常见的致盲眼病。通常继发于眼后段广泛的缺血性疾病,如糖尿病视网膜病变(diabetic retinopathy, DR),视网膜静脉阻塞(retinal vein occlusion, RVO)等。NVG的临床特点主要为难以控制的高眼压和剧烈眼痛,同时行常规青光眼治疗往往无效,最终常导致视功能的严重丧失甚至眼球摘除等后果。然而,早期的诊断、积极的预防和有效的治疗等措施是可以达到控制病情发展和保留较好视功能的目的。目前,对于NVG的具体发病机制尚不清楚,但国内外对它的研究却从未间断。随着分子生物学和免疫学的发展,与新生血管形成有关的一些细胞因子及其受体的研究越来越受到眼科学界的关注。血管内皮生长因子(vascular endothelial growth factor, VEGF)是一种具有特异性地刺激血管内皮细胞增殖及新生血管形成的血小板源性蛋白。白细胞介素-6(interleukin, IL-6)是感染或外伤急性期应激反应的主要诱导因子,也是一种调节炎症反应的多功能细胞因子。本实验的目的在于通过检测NVG患者血清与房水中VEGF和IL-6的水平,观察两者之间以及它们与NVG的关系,进一步明确促血管生长因子对NVG发病的影响,揭示NVG可能的发病机理;并通过血清与房水中血管因子的相关性研究,试图找到能够反应眼内液相关因子水平情况的指标,为临床早期预测、评估病情和判断预后提供相关理论依据。方法:选取NVG患者20例作为实验组(A组),原发性慢性闭角型青光眼患者(B组)作为高眼压对照组20例、老年性白内障患者(C组)作为正常对照组20例。采集三组患者血清及房水标本,通过双抗体夹心酶联免疫吸附试验方法(enzyme-linked immuno sorbent assay, ELISA法)分别检测血清与房水中VEGF、IL-6的浓度水平。比较VEGF、IL-6水平在各组间的差异;分析各组VEGF与IL-6的相关性;研究各组VEGF、IL-6在血清与房水间的浓度差异及其相关性。应用SPSS17.0统计软件处理数据,同组内同一因子在不同标本间的数据比较用独立样本的t检验;所有数据均具有方差齐性,不同组间的各因子比较用方差分析(ANOVA)。相关性分析采用Pearson相关系数检验。P0.05表示差异具有统计学意义。结果:1.各组VEGF、IL-6的浓度水平: ①房水中VEGF的浓度水平:A组(1336.80±70.15)pg/ml明显高于B组(311.60±31.06)pg/ml和C组(165.75±13.95)pg/ml,三组间两两比较,差异均具有统计学意义(F=4019.334, P0.05)。 ②房水中IL-6的浓度水平: A组(691.15±50.09)pg/ml明显高于B组(168.25±11.95)pg/ml和C组(92.10±9.59)pg/ml,三组间两两比较,差异均具有统计学意义(F=2275.019,P0.05)。 ③血清中VEGF的浓度水平:A组(545.40±155.49)pg/ml高于B组(321.15±52.57)pg/ml和C组(176.30±20.38)pg/ml,三组间两两比较,差异均具有统计学意义(F=75.940,P0.05)。 ④血清中IL-6的浓度水平: A组(291.35±22.66)pg/ml高于B组(104.35±13.21)pg/ml和C组(87.00±12.70)pg/ml,三组间两两比较,差异均具有统计学意义(F=906.947,P0.05)。 2.NVG组房水中VEGF与IL-6的水平呈显著的正相关性,差异具有统计学意义(r=0.857,P0.05)。其余各组标本中无显著的相关性(P0.05)。 3.NVG组患者房水中VEGF、IL-6的含量明显高于血清中,差异具有统计学意义(t=-20.748,P0.05;t= -32.199,P0.05)。 4.各组血清中VEGF、IL-6浓度与相应房水中的含量无显著的相关性(P0.05)。结论:1. VEGF、IL-6可能促进了NVG的发生发展。 2. VEGF、IL-6在NVG的形成过程中,具有相互协同的作用。 3. NVG眼局部可能存在着VEGF、IL-6独立的产生和作用机制。
[Abstract]:Objective: neovascular glaucoma (NVG) is a complicated, clinically severe refractory, refractory glaucoma, which is a common blind eye disease. It is usually secondary to extensive ischemic diseases in the posterior segment of the eye, such as diabetic retinopathy (diabetic retinopathy, DR), retinal vein occlusion (retinal vein). Occlusion, RVO) and other clinical features of.NVG are mainly difficult to control high intraocular pressure and severe ocular pain, and routine glaucoma treatment is often ineffective, and eventually results in severe loss of visual function and even exucleation of the eyeball. However, early diagnosis, active prevention and effective treatment are possible to control the development of the disease and At present, the specific pathogenesis of NVG is not clear, but the research at home and abroad has never been interrupted. With the development of molecular biology and immunology, the research of some cytokines and their receptors related to the formation of neovascularization has attracted more and more attention in the field of Ophthalmology. Vascular endothelial growth factor (v Ascular endothelial growth factor, VEGF) is a kind of thrombocytopenia that specifically stimulates the proliferation of vascular endothelial cells and the formation of neovascularization. Interleukin -6 (interleukin, IL-6) is the main inducer of the acute stress response to infection or trauma, and is also a multifunctional cytokine that regulates the inflammatory response. The purpose of the experiment is to observe the relationship between the serum and the VEGF and IL-6 levels in the NVG patients and the aqueous humor, to observe the relationship between the two and the NVG, to further clarify the effect of vascular growth factor on the pathogenesis of NVG and to reveal the possible pathogenesis of NVG, and to try to find a response through the study of the correlation between serum and blood tube factors in the aqueous humor. Indicators of the level of intraocular fluid related factors provide a theoretical basis for early clinical prediction, assessment of disease and prognosis.
Methods: 20 cases of NVG patients were selected as experimental group (group A), 20 cases of primary chronic angle closure glaucoma (group B), 20 cases of high intraocular pressure control group and 20 cases of senile cataract (group C) as the normal control group. The serum and aqueous humor samples were collected and the double anti body sandwich enzyme-linked immunosorbent assay (enzyme-linked immuno sorbe) was used. NT assay, ELISA method) detection of serum and aqueous VEGF, IL-6 concentration level respectively. Compare the difference between VEGF and IL-6 levels in each group; analyze the correlation between VEGF and IL-6 in each group; study the difference and correlation between the concentration of VEGF, IL-6 in the serum and the aqueous humor in each group. The same factor in the same group is different with the same factor in the same group. The data in this room were compared with the t test of independent samples; all the data were homogeneity of variance, and the factors of different groups were compared with the analysis of variance (ANOVA). The correlation analysis used the Pearson correlation coefficient to test.P0.05 to indicate that the difference was statistically significant.
Results: 1. the concentration level of VEGF and IL-6 in each group:
(1) the concentration level of VEGF in aqueous humor: group A (1336.80 + 70.15) pg/ml was significantly higher than that of group B (311.60 + 31.06) pg/ml and C (165.75 + 13.95) pg/ml, and 22 of the three groups were statistically significant (F=4019.334, P0.05).
(2) the concentration level of IL-6 in aqueous humor: group A (691.15 + 50.09) pg/ml was significantly higher than that of group B (168.25 + 11.95) pg/ml and C (92.10 + 9.59) pg/ml, and 22 of the three groups were statistically significant (F=2275.019, P0.05).
(3) the level of serum VEGF concentration: group A (545.40 + 155.49) pg/ml was higher than that of group B (321.15 + 52.57) pg/ml and C group (176.30 + 20.38) pg/ml, and 22 of the three groups were statistically significant (F=75.940, P0.05).
(4) the level of serum IL-6 concentration: group A (291.35 + 22.66) pg/ml was higher than that of group B (104.35 + 13.21) pg/ml and C group (87 + 12.70) pg/ml, and 22 of the three groups were statistically significant (F=906.947, P0.05).
There was a significant positive correlation between the level of VEGF and IL-6 in the aqueous humor of 2.NVG group, and the difference was statistically significant (r=0.857, P0.05). There was no significant correlation between the other groups (P0.05).
In group 3.NVG, the levels of VEGF and IL-6 in aqueous humor were significantly higher than those in serum, and the difference was statistically significant (t=-20.748, P0.05, t= -32.199, P0.05).
4. there was no significant correlation between serum VEGF and IL-6 concentration and the content of corresponding aqueous humor in each group (P0.05).
Conclusion: 1. VEGF and IL-6 may promote the occurrence and development of NVG.
2. VEGF, IL-6 plays a synergistic role in the formation of NVG.
3. there may be VEGF and IL-6 independent production and mechanism in NVG eyes.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R775

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