Conbercept對增殖型糖尿病視網(wǎng)膜病變眼內(nèi)PIGF的影響
發(fā)布時間：2018-08-31 12:56
【摘要】：目的:測定增殖型糖尿病視網(wǎng)膜病變(proliferative diabetic retinopathy,PDR)患者房水及玻璃體液中血管內(nèi)皮生長因子(vascular endothelial growth factor,VEGF)和胎盤生長因子(placenta growth factor,Pl GF)濃度及玻璃體腔康柏西普(intravitreal Conbercept,IVC)注射后房水及玻璃體液中VEGF和Pl GF濃度變化以及兩種細(xì)胞因子之間的相關(guān)性。進(jìn)一步探討Pl GF在PDR發(fā)病機(jī)制中的作用,為防治PDR病變提供理論依據(jù)。方法:收集2015年12月至2016年12月就診于我院的25例患者納入研究,實驗組為PDR患者16例,分為A(8例9眼)、B(8例9眼)兩組。A組行IVC注射聯(lián)合玻璃體切割術(shù),分別在IVC注射前收集房水,在IVC注射7天后行玻璃體切割術(shù)中收集房水及玻璃體液。B組行單純玻璃體切割術(shù),在術(shù)中收集房水及玻璃體液。對照組(9例9眼)為孔源性視網(wǎng)膜脫離需要行玻璃體切割術(shù)的非糖尿病患者,在術(shù)中收集房水及玻璃體液。通過酶聯(lián)免疫吸附測定法(enzyme-linked immunosorbent assay,ELISA)檢測房水及玻璃體液中VEGF和Pl GF濃度。監(jiān)測各組術(shù)后1周、1月及3月的最佳矯正視力(best corrected visual acuity,BCVA)以及實驗組術(shù)后3月黃斑中心凹厚度(central macular thickness,CMT)。結(jié)果:1、實驗組A IVC注藥前房水中VEGF和Pl GF平均濃度分別為(269.255±118.1),(355.464±204.875)pg/ml;IVC注藥后房水平均濃度分別為(128.712±60.692),(219.622±151.487)pg/ml;實驗組B房水中VEGF和Pl GF平均濃度分別為(301.0291±173.582),(478.733±273.873)pg/ml;對照組房水中VEGF和Pl GF平均濃度分別為(11.751±5.53),(12.363±7.279)pg/ml。實驗組A IVC注藥前和實驗組B房水中VEGF與Pl GF濃度顯著高于對照組(Z=-3.578,P0.05);注藥前后房水中VEGF與Pl GF濃度具有顯著差異(Z=-2.666,P0.05);實驗組A IVC注藥前與實驗組B房水中VEGF、Pl GF濃度均無顯著差異(Z=-0.221,-0.927,P0.05)。2、實驗組B玻璃體中VEGF和Pl GF平均濃度分別為(911.804±330.925),(763.774±373.526)pg/ml;對照組玻璃體中VEGF和Pl GF平均濃度分別為(41.964±10.115),(40.742±20.27)pg/ml。實驗組B與對照組玻璃體中VEGF、Pl GF濃度比較均具有顯著差異(Z=-3.584,-3.578,P0.05)。3、實驗組A IVC注藥前(r=0.683,P0.05)與注藥后(r=0.800,P0.05)以及實驗組B(r=0.700,P0.05)房水VEGF和Pl GF濃度均有正相關(guān)關(guān)系;對照組房水VEGF和Pl GF濃度無顯著相關(guān)性(r=0.075,P0.05)。4、實驗組A IVC注藥后(r=0.567,P0.05)與對照組(r=0.375,P0.05)玻璃體VEGF和Pl GF濃度無顯著相關(guān)性;實驗組B玻璃體VEGF和Pl GF濃度之間有正相關(guān)關(guān)系(r=0.867,P0.05)。5、實驗組A IVC注藥后房水與玻璃體中VEGF濃度有正相關(guān)關(guān)系(r=0.800,P0.05),Pl GF濃度有正相關(guān)關(guān)系(r=0.833,P0.05);實驗組B房水與玻璃體中VEGF濃度有正相關(guān)關(guān)系(r=0.717,P0.05),Pl GF濃度有正相關(guān)關(guān)系(r=0.800,P0.05);對照組房水與玻璃體中VEGF濃度無顯著相關(guān)性(r=0.519,P0.05),Pl GF濃度無顯著相關(guān)性(r=0.435,P0.05)。6、術(shù)后3月平均log MAR BCVA實驗組A為0.743±0.487;實驗組B為1.147±0.95;對照組為0.48±0.199。三組與術(shù)前BCVA對比均有所提高(t=9.463,P0.05)但實驗組A與B術(shù)后3月log MAR BCVA之間無顯著差異(t=-1.134,P0.05);實驗組A與實驗組B術(shù)后3月平均CMT分別為267.778±120.695μm(范圍:152~548μm)410.889±213.542μm(范圍:179~769μm),兩組之間無顯著差異(Z=-1.546,P0.05)。結(jié)論:1、PDR患者房水及玻璃體液高濃度VEGF及Pl GF可能與眼內(nèi)新生血管發(fā)生、發(fā)展密切相關(guān)。2、經(jīng)IVC注射治療后房水及玻璃體中VEGF和Pl GF濃度均有所下降,表明Conbercept對VEGF和Pl GF有較好的抑制作用。3、PDR患者房水及玻璃體中Pl GF濃度與VEGF濃度顯著的相關(guān),表明兩種細(xì)胞因子之間可能存在相互調(diào)節(jié)作用,并且細(xì)胞因子的產(chǎn)生主要在視網(wǎng)膜局部。4、PDR患者經(jīng)IVC注射聯(lián)合23G微創(chuàng)玻璃體切割術(shù),可以提高術(shù)后視力,但術(shù)后視力改善與是否行IVC治療無明顯關(guān)系,術(shù)后視力提高與CMT呈負(fù)相關(guān)。
[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.
【學(xué)位授予單位】：西安醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R587.2;R774.1
本文編號：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.
【學(xué)位授予單位】：西安醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R587.2;R774.1
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 易偉華,魏銳利,蔡季平,李玉莉;血管內(nèi)皮生長因子和轉(zhuǎn)化生長因子β_1在眼眶海綿狀血管瘤的表達(dá)及意義[J];國際眼科雜志;2004年02期
，本文編號：2215051
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