雷珠單抗對(duì)增殖性糖尿病視網(wǎng)膜病變眼部VEGF家族及玻璃體切割術(shù)的影響
發(fā)布時(shí)間：2018-07-23 08:35
【摘要】：目的:觀察玻璃體腔注射雷珠單抗(IVR)對(duì)增殖性糖尿病視網(wǎng)膜病變(PDR)患者房水、玻璃體液及增殖膜中血管內(nèi)皮生長因子(VEGF)-A、VEGF-B和胎盤生長因子(PIGF)表達(dá)及對(duì)玻璃體切割術(shù)的影響。方法:選取臨床確診PDR患者60例60只眼納入研究,隨機(jī)分為單純玻璃體切割手術(shù)(PPV)組和IVR聯(lián)合PPV組,各30只眼。單純手術(shù)治療組眼于PPV手術(shù)時(shí)抽取房水、玻璃體液及剝離增殖膜;聯(lián)合藥物治療組眼于IVR治療前抽取房水及IVR治療7天后聯(lián)合PPV抽取房水、玻璃體液及剝離增殖膜;采用酶聯(lián)免疫吸附測定(ELISA)法檢測房水、玻璃體液中VEGF-A、VEGF-B及PIGF含量;組織化學(xué)染色測定增殖膜中VEGF-A、VEGF-B及PIGF水平;蘇木素-伊紅染色(HE染色)觀察增殖膜中血管數(shù)目;觀察兩組手術(shù)時(shí)間、術(shù)中出血嚴(yán)重程度。結(jié)果:聯(lián)合藥物治療組IVR治療后較治療前房水中VEGF-A含量明顯降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05);聯(lián)合藥物治療組IVR治療前后房水中VEGF-B、PIGF含量比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。聯(lián)合藥物治療組(IVR術(shù)后)房水、玻璃體液及增殖膜中VEGF-A含量較對(duì)照組明顯降低,差異有統(tǒng)計(jì)學(xué)差異(P0.05)。聯(lián)合藥物治療(IVR術(shù)后)較單純手術(shù)治療組房水、玻璃體液及增殖膜中VEGF-B及PIGF含量無明顯變化,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。與單純手術(shù)治療組比較,聯(lián)合藥物治療組增殖膜中血管數(shù)目、術(shù)中出血嚴(yán)重程度、手術(shù)時(shí)間明顯降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:玻璃體腔注射雷珠單抗明顯降低PDR患者房水、玻璃體液及增殖膜中VEGF-A含量并使增殖膜中血管數(shù)目明顯減少,減少手術(shù)時(shí)間、減輕術(shù)中出血嚴(yán)重程度,提高PPV手術(shù)的安全性,雷珠單抗可以降低房水、玻璃體液及增殖膜中VEGF-B及PIGF含量但沒有統(tǒng)計(jì)學(xué)意義。
[Abstract]:Aim: to investigate the effects of intravitreous injection of Lei Zhu McAb (IVR) on the expression of vascular endothelial growth factor (VEGF) and placental growth factor (PIGF) in aqueous humor, vitreous fluid and proliferative membrane of patients with proliferative diabetic retinopathy (PDR) and vitrectomy. Methods: 60 cases (60 eyes) of PDR were randomly divided into simple vitrectomy (PPV) group and IVR combined PPV group (30 eyes each). Aqueous humor, vitreous fluid and exfoliation of proliferative membrane were extracted from eyes of simple operation group during PPV operation, and aqueous humor, vitreous fluid and stripping of proliferative membrane were extracted from eyes of combined drug treatment group before IVR treatment and 7 days after IVR treatment. The contents of VEGF-B and PIGF in aqueous humor and vitreous fluid were detected by enzyme-linked immunosorbent assay (Elisa), the levels of VEGF-B and PIGF in proliferative membrane were detected by histochemical staining, and the number of blood vessels in proliferative membrane was observed by hematoxylin eosin staining (HE staining). The time of operation and the severity of intraoperative bleeding were observed. Results: the content of VEGF-A in aqueous humor of the combined drug treatment group was significantly lower than that before and after treatment (P0.05), but there was no significant difference between the two groups before and after IVR treatment (P0.05). The content of VEGF-A in aqueous humor, vitreous fluid and proliferative membrane in the combined drug therapy group (IVR postoperative) was significantly lower than that in the control group (P0.05). The contents of VEGF-B and PIGF in aqueous humor, vitreous fluid and proliferative membrane in IVR group were not significantly changed compared with those in simple operation group (P0.05). Compared with the simple operation group, the number of blood vessels in the proliferative membrane, the severity of intraoperative bleeding and the operation time in the combined drug group were significantly lower than those in the control group (P0.05). Conclusion: injection of Leizhu McAb into vitreous body cavity can significantly reduce the content of VEGF-A in aqueous humor, vitreous fluid and proliferative membrane in PDR patients, reduce the number of blood vessels in proliferative membrane, reduce the operation time and reduce the severity of intraoperative bleeding. In order to improve the safety of PPV, the content of VEGF-B and PIGF in aqueous humor, vitreous body fluid and proliferative membrane were decreased by Leizhu McAb, but there was no significant difference in the content of VEGF-B and PIGF.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.2;R779.6
本文編號(hào)：2138825
[Abstract]:Aim: to investigate the effects of intravitreous injection of Lei Zhu McAb (IVR) on the expression of vascular endothelial growth factor (VEGF) and placental growth factor (PIGF) in aqueous humor, vitreous fluid and proliferative membrane of patients with proliferative diabetic retinopathy (PDR) and vitrectomy. Methods: 60 cases (60 eyes) of PDR were randomly divided into simple vitrectomy (PPV) group and IVR combined PPV group (30 eyes each). Aqueous humor, vitreous fluid and exfoliation of proliferative membrane were extracted from eyes of simple operation group during PPV operation, and aqueous humor, vitreous fluid and stripping of proliferative membrane were extracted from eyes of combined drug treatment group before IVR treatment and 7 days after IVR treatment. The contents of VEGF-B and PIGF in aqueous humor and vitreous fluid were detected by enzyme-linked immunosorbent assay (Elisa), the levels of VEGF-B and PIGF in proliferative membrane were detected by histochemical staining, and the number of blood vessels in proliferative membrane was observed by hematoxylin eosin staining (HE staining). The time of operation and the severity of intraoperative bleeding were observed. Results: the content of VEGF-A in aqueous humor of the combined drug treatment group was significantly lower than that before and after treatment (P0.05), but there was no significant difference between the two groups before and after IVR treatment (P0.05). The content of VEGF-A in aqueous humor, vitreous fluid and proliferative membrane in the combined drug therapy group (IVR postoperative) was significantly lower than that in the control group (P0.05). The contents of VEGF-B and PIGF in aqueous humor, vitreous fluid and proliferative membrane in IVR group were not significantly changed compared with those in simple operation group (P0.05). Compared with the simple operation group, the number of blood vessels in the proliferative membrane, the severity of intraoperative bleeding and the operation time in the combined drug group were significantly lower than those in the control group (P0.05). Conclusion: injection of Leizhu McAb into vitreous body cavity can significantly reduce the content of VEGF-A in aqueous humor, vitreous fluid and proliferative membrane in PDR patients, reduce the number of blood vessels in proliferative membrane, reduce the operation time and reduce the severity of intraoperative bleeding. In order to improve the safety of PPV, the content of VEGF-B and PIGF in aqueous humor, vitreous body fluid and proliferative membrane were decreased by Leizhu McAb, but there was no significant difference in the content of VEGF-B and PIGF.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.2;R779.6
【參考文獻(xiàn)】
相關(guān)期刊論文 前3條
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2 ZHANG XinYuan;LIU Wei;WU ShanShan;JIN JingLong;LI WeiHong;Wang NingLi;;Calcium dobesilate for diabetic retinopathy: a systematic review and meta-analysis[J];Science China(Life Sciences);2015年01期
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