發(fā)布時(shí)間：2018-05-07 20:21

  本文選題：PFKFB3 + VEGF��； 參考：《西南醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過定量檢測增殖型糖尿病性視網(wǎng)膜病變(proliferative diabetic retinopathy,PDR)患者玻璃體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)和血管內(nèi)皮細(xì)胞生長因子(vascular endothelial growth factor,VEGF)的表達(dá)水平,并進(jìn)行相關(guān)性分析,探討PFKFB3在PDR發(fā)生發(fā)展中可能的作用機(jī)制。方法:本研究納入2015年12月5日至2017年1月19日經(jīng)門診診斷為PDR擬行單眼玻璃體切除術(shù)的患者42例(A組),其中男24例,女18例,平均年齡55.43±9.29歲,并據(jù)患者玻璃體切除術(shù)前是否行玻璃體腔注射抗VEGF藥物進(jìn)一步分為非注藥組(A1組)和注藥組(A2組),其中,A1組16例,男9例,女7例,平均年齡54.88±9.46歲;A2組26例,男15例,女11例,平均年齡55.77±9.35歲。將同期診斷為全層黃斑裂孔(full thickness macular hole,FTMH)及黃斑前膜(preretinal membrane of the macula,PRMM)并符合納入標(biāo)準(zhǔn)的20例患者作為對照組(B組),其中,男12例,女8例,平均年齡53.95±10.21歲,各組年齡及性別構(gòu)成比無統(tǒng)計(jì)學(xué)差異(P=0.054)。所有患者均經(jīng)睫狀體平坦部行25G+微創(chuàng)玻璃體切除術(shù),所有手術(shù)均由同一位教授完成。收集各組患者的玻璃體和血清標(biāo)本,離心取上清,分裝后凍存。酶聯(lián)免疫吸附試驗(yàn)(enzyme-linked immunosorbent assay,ELISA)定量檢測玻璃體和血清標(biāo)本中的PFKFB3和VEGF表達(dá)水平,采用SPSS19.0統(tǒng)計(jì)學(xué)軟件對各組數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1、A組患者玻璃體中PFKFB3水平(463.17±381.28pg/mL)明顯高于B組(158.43±86.88pg/ml)(t=4.919,p0.001),a組血清中pfkfb3水平(153.45±83.78pg/ml)明顯高于b組(92.72±32.42pg/ml)(t=4.098,p0.001)。a1組患者玻璃體中pfkfb3水平(797.29±387.44pg/ml)明顯高于a2組(257.56±181.49pg/ml)(t=5.230,p0.001),而a1組血清中pfkfb3水平(164.72±102.57pg/ml)與a2組(146.52±71.18pg/ml)差異無統(tǒng)計(jì)學(xué)意義(t=0.679,p=0.501)。a1、a2和b組患者玻璃體和血清中的pfkfb3水平未見相關(guān)性(a1組r=0.194,p=0.471;a2組r=0.071,p=0.731;b組r=0.254,p=0.279)2、a組患者玻璃體中vegf水平(1713.50±1386.90pg/ml)明顯高于b組(205.52±92.93pg/ml)(t=7.014,p0.001);a組血清中vegf水平(224.98±168.08pg/ml)明顯高于b組(86.80±36.51pg/ml)(t=5.082,p0.001)。a1組患者玻璃體中vegf水平(3399.72±510.06pg/ml)明顯高于a2組(675.82±242.57pg/ml)(t=20.014,p0.001),a1組血清中vegf水平(373.40±174.23pg/ml)亦明顯高于a2組(133.65±73.10pg/ml)(t=5.228,p0.001)。a1、a2和b組患者玻璃體和血清中的vegf水平均存在正相關(guān)關(guān)系(a1組r=0.952,p0.001;a2組r=0.423,p=0.031;b組r=0.776,p0.001)。3、a1、a2和b組患者玻璃體中pfkfb3與vegf水平均存在正相關(guān)關(guān)系(a1組r=0.865,p0.001;a2組r=0.587,p=0.002;b組r=0.807,p0.001),而在血清中僅a2組的pfkfb3與vegf水平存在正相關(guān)關(guān)系(r=0.444,p=0.023),a1組和b組均無明顯相關(guān)性(a1組r=-0.130,p=0.631;b組r=0.045,p=0.849)。結(jié)論:pdr患者玻璃體和血清中的pfkfb3水平均較對照組患者升高,其可能參與了PDR的發(fā)生發(fā)展過程;玻璃體腔注射抗VEGF藥物后可引起玻璃體及血清中VEGF降低,同時(shí)可降低玻璃體腔PFKFB3水平降低,提示VEGF可能通過上調(diào)PFKFB3的表達(dá)而參與PDR的發(fā)生發(fā)展,為DR發(fā)病機(jī)制的進(jìn)一步研究提供新的理論依據(jù);玻璃體腔注射抗VEGF藥物后血清中PFKFB3濃度差異無統(tǒng)計(jì)學(xué)意義。
[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 鹵 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 鹵 2.57pg / ml ) ( t = 5.071 , p0.001 ) . The vegf level ( 373.40 鹵 174.23pg / ml ) in the serum of group a1 was significantly higher than that in group a2 ( 133.65 鹵 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 .

【學(xué)位授予單位】：西南醫(yī)科大學(xué)
【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4條

1 文哲瑤;陳燕銘;;PFKFB3促進(jìn)糖尿病視網(wǎng)膜微血管損傷[J];新醫(yī)學(xué);2016年11期

2 劉飛飛;劉靜;吳謂;劉穎;羅瑛;張繼虹;;靶向內(nèi)皮細(xì)胞糖酵解限速酶PFKFB3的抗腫瘤血管生成研究進(jìn)展[J];腫瘤;2016年01期

3 單俊杰;袁志蘭;曹國平;;玻璃體腔注射貝伐單抗Avastin后糖尿病視網(wǎng)膜患者血清中VEGF含量的變化研究[J];臨床眼科雜志;2014年04期

4 王歡;張含;孫鵬;谷峰;董潔;傅博;劉哲麗;;視網(wǎng)膜血管性疾病患者玻璃體液中血管內(nèi)皮生長因子和腫瘤壞死因子-α的含量測定[J];中華眼底病雜志;2012年05期

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