糖尿病视网膜病变患者视网膜组织学改变和细胞生化检测指标异常分析

The changes of histology and biochemical parameters in retina of the patient with diabetic retinopathy

目的 评价糖尿病患者视网膜组织学改变和细胞生化检测指标异常。方法 将视网膜分为 4个象限 ,胰酶消化法分离视网膜血管 ,比较各象限病变程度 ,将颞侧和鼻侧视网膜匀浆后检测其细胞生化指标。结果 视网膜微动脉瘤、无细胞血管及凋亡周细胞的数量以颞侧多于鼻侧。视网膜各象限的糖转移因子、蛋白激酶C β、半胱氨酸蛋白酶 1的检测结果明显不同。 结论 视网膜微血管病变和细胞生化检测指标异常程度在糖尿病视网膜病变患者视网膜的 4个象限分布不均 ,推测其分布差异在糖尿病视网膜病变的发生、发展中起重要作用。

Objective To observe and estimate the distribution the changes of histology an d biochemical parameters in retina of the patient with diabetic retinopathy. Methods Retinas were divided into quadrants and the lesions of diabetic retinopathy were compared among quadrants. the vasculature was isolated by trypsin-digest, hom ogenates taken from temporal and nasal quadrant were used to explore regional di fferences in the expression of Glut-1, PKCβand activity of caspases1. Results Microaneurysms, acellular capillaries and pericytes ghosts were significantly i ncreased in the temporal retina than in the nasal retina. Activity of the pro- inflammatory protease, caspase l, was the only biochemical abnormality which was found significantly difference between quadrants. Glut-1 expression was decre ased in diabetes, but there was no significant difference between quadrants. Ex pression of PKCβin both temporal and nasal retina was tended to be greater in d iabetic than in non diabetic patients.Conclusion Retinal microvascular disease does not develop uniformly across the retina, even the d ifferent regions are exposed to the same level of hyperglycemia. Regional diffe rences play an important role in the response of the retinal microvasculature to hyperglycemia.(Chin J Ophthalmol, 2004,40:689-691)