本文選題：閾值下577nm微脈沖激光 + 血管內(nèi)皮生長因子��； 參考：《南方醫(yī)科大學》2017年碩士論文

【摘要】：第一章閾值下577nm微脈沖激光光凝對早期糖尿病大鼠視網(wǎng)膜VEGF、NGF和Chemerin的影響目的觀察閾值下577nm微脈沖激光光凝對早期糖尿病大鼠視網(wǎng)膜血管內(nèi)皮生長因子(Vascular endothelial growth factor,VEGF)、神經(jīng)生長因子(Nerve growth factor,NGF)和趨化素(Chemerin)的影響。方法采用65mg·kg-1鏈脲佐菌素對40只棕色挪威(Brown Norway,BN)大鼠建立糖尿病大鼠模型。造模成功后2周選取20只大鼠,采用lQ577nm(美國IRIDEX公司)激光行閾值下微脈沖激光處理。先將激光調(diào)成連續(xù)波模式在右眼周邊部視網(wǎng)膜行閾能量測定,設(shè)定光斑直徑:200 μm,曝光時間200sm,設(shè)定視網(wǎng)膜剛變白時的能量為閾值能量。然后轉(zhuǎn)換成微脈沖模式,微脈沖激光參數(shù):光斑直徑:200 μ m,曝光時間200sm,負載系數(shù)5%,400%的閾能量,在視盤周圍以4點距陣方法行200個光凝點。左眼不做任何處理,作為對照組。在微脈沖激光光凝后3d、7d、14d、28d隨機各選取5只大鼠,應(yīng)用實時熒光定量PCR和Western blot方法檢測BN大鼠雙眼視網(wǎng)膜VEGF、NGF和Chemerin表達情況。結(jié)果對照組VEGFmRNA和蛋白在3d、7d、14d、28d表達均增加,差異有統(tǒng)計學意義(P0.05);微脈沖激光組VEGF mRNA和蛋白在3d、7d、14d、28d相比于對照組下降,差異有統(tǒng)計學意義(均為P0.05)。對照組3d、7d、14d、28d NGF mRNA和蛋白逐漸下降(P0.05),7d NGF比3d下降,差異無統(tǒng)計學意義(P0.05);微脈沖激光組NGFmRNA和蛋白在3d、7d、14d、28d相比于對照組上升,且在14d達到峰值,差異有統(tǒng)計學意義(均為P0.05)。對照組ChemerinmRNA和蛋白在3d、7d、14d、28d表達均增加,差異有統(tǒng)計學意義(P0.05);微脈沖激光組ChemerinmRNA和蛋白在3d、7d、14d、28d相比于對照組下降,差異有統(tǒng)計學意義(均為P0.05)。結(jié)論閾值下577nm微脈沖激光光凝可降低早期糖尿病大鼠視網(wǎng)膜VEGF、Chemerin表達,上調(diào)NGF表達。第二章 比較傳統(tǒng)激光光凝與閾值下微脈沖激光光凝對增生型糖尿病性視網(wǎng)膜病變患者玻璃體組織內(nèi)VEGF、IL-33及NO濃度的影響目的 對比傳統(tǒng)激光光凝與閾值下微脈沖激光光凝對增生型糖尿病性視網(wǎng)膜病變(Proliferative diabetic retinopathy,PDR)患者玻璃體組織中血管內(nèi)皮生長因子(Vascular endothelial growth factor,VEGF),白細胞介素-33(Interleukin-33,IL-33)和一氧化氮(Nitric oxide,NO)濃度的影響。方法 確診為PDR患39例39只眼納入研究。將就診患者分為傳統(tǒng)激光治療PDR(15例15只眼)、閾值下微脈沖激光光凝治療PDR(13例13只眼)組和未行任何激光治療的PDR(11例11只眼)。同時11例11只眼特發(fā)性黃斑皺褶(Idiopathic macular pucker,IMP)患者作為非糖尿病對照組。兩組激光治療后3天及及所有入組患眼均行常規(guī)玻璃體切割術(shù)。術(shù)中收集患者玻璃體組織,采用酶聯(lián)免疫吸附法測定玻璃體組織中VEGF、IL-33、NO濃度,術(shù)后行光相干斷層掃描測量黃斑中心凹厚度。對比傳統(tǒng)激光與閾值下微脈沖激光光凝對PDR患者玻璃體組織中VEGF、IL-33及NO濃度的影響,分析各組蛋白濃度與黃斑中心凹厚度相關(guān)性。結(jié)果未行任何激光治療的PDR組VEGF濃度最高,高于傳統(tǒng)激光治療PDR組(P=0.005),高于閾值下微脈沖激光光凝治療PDR組(P=0.018),高于IMP組(P0.001);傳統(tǒng)激光治療PDR組與閾值下微脈沖激光光凝治療PDR組VEGF濃度無統(tǒng)計學差異(P=0.69)。傳統(tǒng)激光治療PDR組IL-33濃度最高,高于閾值下微脈沖激光光凝治療PDR組(P=0.001),高于未行任何激光治療的PDR組(P0.001),高于IMP組(P0.001);閾值下微脈沖激光光凝治療PDR組和未行任何激光治療的PDR組IL-33濃度無統(tǒng)計學差異(P=0.30)。IMP組NO濃度最低,低于傳統(tǒng)激光治療PDR組(P0.001),低于閾值下微脈沖激光光凝治療PDR組(P0.001),低于未行任何激光治療的PDR組(P0.001)。傳統(tǒng)激光治療PDR組與閾值下微脈沖激光光凝治療PDR組NO濃度無差異(P=0.23)。在未行任何激光治療的PDR組內(nèi),CFT與NO濃度具有相關(guān)性(r=0.67,P=0.025)。結(jié)論氪激光光凝與閾值下微脈沖激光光凝在3天后可降低PDR患玻璃體組織中VEGF濃度,閾值下微脈沖激光光凝產(chǎn)生的炎性反應(yīng)更小。
[Abstract]:The effects of 577nm micropulse laser photocoagulation on VEGF, NGF and Chemerin in the retina of early diabetic rats under threshold value were observed. Objective To observe the retinal vascular endothelial growth factor (Vascular endothelial growth factor, VEGF) and nerve growth factor (Nerve growth) in early diabetic rats under the threshold value of 577nm micropulse laser The effect of chemokine (Chemerin). Methods the diabetic rat model was established by 65mg kg-1 streptozotocin in 40 brown Norway (Brown Norway, BN) rats. 20 rats were selected at 2 weeks after the model was successful, and the laser irradiation threshold of lQ577nm (American IRIDEX company) was used. Retina line threshold energy measurement, setting light spot diameter: 200 mu m, exposure time 200sm, setting the energy of the retinal rigid white energy as threshold energy. Then convert into micro pulse mode, micro pulse laser parameters: light spot diameter: 200 mu m, exposure time 200sm, load coefficient 5%, 400% threshold energy, 200 photocoagulation around disc 4 point array method around the disc. The left eye did not do any treatment, as the control group. After the micro pulse laser photocoagulation 3D, 7d, 14d, 28d randomly selected 5 rats, the real time fluorescence quantitative PCR and Western blot methods were used to detect the VEGF, NGF and Chemerin expression in the retina of BN rats. The VEGF mRNA and protein in the micro pulse laser group decreased in 3D, 7d, 14d, and 28d compared to the control group, and the difference was statistically significant (all P0.05). The control group was 3D, 7d, 14d, 28d, and protein gradually descended. In the control group, the difference was statistically significant (P0.05). The expression of ChemerinmRNA and protein in the control group increased in 3D, 7d, 14d, 28d, and the difference was statistically significant (P0.05). The difference was statistically significant compared with the control group (3D, 7d, 14d, and 14d). The difference was statistically significant (all 14d). 577nm micropulse laser photocoagulation can reduce the VEGF, Chemerin expression and up regulation of NGF expression in the retina of early diabetic rats. The second chapter compares the traditional laser photocoagulation and the threshold of micropulse laser photocoagulation to the concentration of VEGF, IL-33 and NO in the vitreous tissue of patients with proliferative diabetic retinopathy The effect of the concentration of vascular endothelial growth factor (Vascular endothelial growth factor, VEGF), interleukin -33 (Interleukin-33, IL-33) and nitric oxide in the vitreous tissue of patients with proliferative diabetic retinopathy (Proliferative diabetic retinopathy, PDR) by coagulation and threshold micropulse laser photocoagulation. The patients were diagnosed as PDR with 39 eyes in 39 cases. The patients were divided into traditional laser treatment PDR (15 cases 15 eyes), PDR (13 cases, 13 eyes) and PDR (11 cases, 11 eyes) without laser treatment under threshold, and 11 patients with 11 eyes (Idiopathic macular pucker, IMP) as non diabetic patients in 11 eyes. Normal vitrectomy was performed at 3 days after the two group of laser treatment and all the eyes of the two groups. The vitreous tissue was collected and the concentration of IL-33, NO in vitreous tissue was measured by enzyme linked immunosorbent assay (ELISA). The thickness of the macular fovea was measured by optical coherence tomography after the operation. The effect of photocoagulation on the concentration of VEGF, IL-33 and NO in the vitreous tissue of PDR patients was analyzed. The correlation between the concentration of protein and the thickness of the macular fovea was analyzed. Results the concentration of VEGF in the PDR group without any laser treatment was the highest, higher than that of the traditional laser therapy group (P=0.005), higher than the threshold of micropulse laser photocoagulation in the PDR group (P=0.018), higher than that of IMP group (P0.0). 01): there was no significant difference between the traditional laser treatment group PDR and the threshold of micropulse laser photocoagulation in group PDR (P=0.69). The concentration of IL-33 in the PDR group was highest in the traditional laser treatment group, higher than that in the PDR group (P=0.001) under the threshold of micropulse laser photocoagulation (P=0.001), higher than that of the group without any laser treatment (P0.001), higher than that of the IMP group (P0.001), and the micro pulse under the threshold value. The concentration of IL-33 in group PDR and PDR group without laser treatment was not statistically significant (P=0.30) in group.IMP, the NO concentration was the lowest, lower than the traditional laser treatment group PDR group (P0.001), lower than the threshold of micropulse laser photocoagulation in group PDR (P0.001), lower than that of no light therapy (P0.001). Traditional laser treatment group and threshold under the threshold There was no difference in the concentration of NO in the PDR group with micropulse laser photocoagulation (P=0.23). In the PDR group without any laser treatment, the concentration of CFT and NO was correlated (r=0.67, P=0.025). Conclusion krypton laser photocoagulation and the threshold of micro pulse laser photocoagulation can reduce the VEGF concentration in the PDR affected vitreous tissue in 3 days, and the inflammatory properties of the micropulse laser photocoagulation at the threshold value. The reaction is smaller.
【學位授予單位】：南方醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R587.2;R779.63

【參考文獻】

相關(guān)期刊論文 前1條

1 Tarek Ahmed Mohamed;Sahar El-deek Mohamed;;視網(wǎng)膜全光凝對糖尿病視網(wǎng)膜病變患者血漿VEGF,ET-1和NO的影響(英文)[J];國際眼科雜志;2009年10期

，

本文編號：1956040