本文選題：糖尿病視網(wǎng)膜病變 + 抗VEGF因子�。� 參考：《天津醫(yī)科大學(xué)》2010年碩士論文

【摘要】： 目的：觀察增殖性糖尿病視網(wǎng)膜病變(proliferative diabetic retinopathy PDR)玻璃體腔注射抗VEGF因子(商品名Avastin)后增殖膜的組織病理學(xué)變化,及增殖膜中血管內(nèi)皮生長(zhǎng)因子(vascular endothelia growth factor, VEGF),結(jié)締組織生長(zhǎng)因子(connective tissue growth factor,CTGF),色素上皮衍生因子(pigment epitheliumderived factor, PEDF)的表達(dá)。 方法：選擇增殖性糖尿病視網(wǎng)膜病變患者24例(26眼),隨機(jī)分組,對(duì)照組直接行玻璃體切割術(shù),研究組玻璃體腔注射抗VEGF因子(商品名Avastin) 10天后行玻璃體切割術(shù),術(shù)中取增殖膜行組織病理學(xué)檢查,觀察糖尿病視網(wǎng)膜增殖膜、新生血管、血管內(nèi)皮細(xì)胞及原始組織細(xì)胞的變化,應(yīng)用免疫組化技術(shù)對(duì)增殖膜中VEGF, CTGF, PEDF各因子的表達(dá)進(jìn)行觀察。 結(jié)果：光鏡下增殖性糖尿病視網(wǎng)膜增殖膜由膠原等細(xì)胞外基質(zhì)以及不同形態(tài)細(xì)胞構(gòu)成,大量新生血管散在分布。研究組的新生血管數(shù)目,血管內(nèi)皮細(xì)胞和原始組織細(xì)胞數(shù)目較對(duì)照組均有下降,差異有統(tǒng)計(jì)學(xué)意義(P＜0.05)。 VEGF表達(dá)：研究組VEGF陽(yáng)性表達(dá)率較對(duì)照組下降,兩組間的陽(yáng)性表達(dá)率差異有統(tǒng)計(jì)學(xué)意義(P＜O.05)。 CTGF表達(dá)：多圍繞新生血管,尤其在較幼稚的血管周圍細(xì)胞表達(dá)明顯,研究組CTGF陽(yáng)性表達(dá)率較對(duì)照組上升,兩組間的陽(yáng)性表達(dá)率差異有統(tǒng)計(jì)學(xué)意義(PO.05)。 PEDF陽(yáng)性染色范圍較廣泛,分布于胞漿內(nèi)、胞核內(nèi)及周圍的膠原基質(zhì)內(nèi),研究組PEDF陽(yáng)性表達(dá)率較對(duì)照組上升,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P＞0.05)。 結(jié)論：玻璃體腔注射抗VEGF因子(商品名Avastin)可以抑制新生血管的形成,使視網(wǎng)膜新生血管消退；糖尿病視網(wǎng)膜病變患者玻璃體腔注射抗VEGF因子后視網(wǎng)膜增殖膜增多,CTGF在增殖膜的表達(dá)明顯增加;PEDF在增殖膜的表達(dá)沒(méi)有明顯變化。
[Abstract]:Objective: to observe the histopathological changes of proliferative diabetic retinopathy after intravitreal injection of anti VEGF factor (Avastin) in proliferative diabetic retinopathy. And the expression of vascular endothelial growth factor (endothelia growth factor,), connective tissue growth factor (CTGF), pigment epithelium-derived factor (epitheliumderived factor, PEDF) in proliferative membrane. Methods: Twenty-six eyes of 24 patients with proliferative diabetic retinopathy were randomly divided into two groups. The control group received vitrectomy directly and the study group received vitrectomy 10 days after injection of anti-Avastin factor (commercial name Avastin). The proliferative membrane was taken for histopathological examination, and the changes of proliferating membrane, neovascularization, vascular endothelial cell and primitive histocyte were observed. The expression of VEGF, CTGF, PEDF factors in proliferative membrane was observed by immunohistochemical technique. Results: the proliferative membrane of proliferative diabetic retina was composed of extracellular matrix such as collagen and different morphologic cells under light microscope, and a large number of neovascularization were scattered. The number of neovascularization, endothelial cells and primordial histocytes in the study group were significantly lower than those in the control group (P < 0.05). VEGF expression: the positive expression rate of VEGF in the study group was lower than that in the control group, and the difference between the two groups was statistically significant (P < 0. 05). The expression of CTGF was mainly around neovascularization, especially in the immature perivascular cells. The positive expression rate of CTGF in the study group was higher than that in the control group, and the difference between the two groups was statistically significant. PEDF positive staining was found in the cytoplasm, nucleus and collagen matrix. The positive expression rate of PEDF in the study group was higher than that in the control group, but the difference was not statistically significant (P > 0.05). Conclusion: intravitreal injection of anti VEGF factor (commercial name Avastin) can inhibit the formation of neovascularization and make retinal neovascularization disappear. The expression of VEGF in proliferative membrane was significantly increased in diabetic retinopathy patients after intravitreal injection of anti VEGF factor.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R774.1

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