血管内皮生长因子在早期糖尿病微血管病变中的变化及意义

The change and significance of serum vascular endothelial growth factor level in the patients with diabetic microvascular complication

目的探讨早期糖尿病微血管病变患者血清中血管内皮生长因子(VEGF)浓度的变化及与病变程度的关系,为糖尿病微血管病变的早期诊断和干预提供理论依据。方法106例2型糖尿病患者依眼底血管荧光造影(FFA)及尿白蛋白排泄率(UAER)结果,将无微量白蛋白尿(UAER<20μg/m in)及视网膜病变的患者定为A组;合并非增殖期糖尿病视网膜病变患者但无微量蛋白尿为B组;合并微量白蛋白尿及非增殖期糖尿病视网膜病变患者为C组;健康对照组为D组。所有患者及健康对照组行血清VEGF测定。结果VEGF水平D组低于A组(P<0.05),A组低于B组,B组低于C组,差异均有显著性(P<0.05)。结论糖尿病患者血清VEGF水平比健康人高,合并微血管病变患者更高,并随病变程度加重而增高;VEGF可能是糖尿病微血管病变发生和发展的重要指标之一。

Objective To evaluate the relationship between the level of vascular endothelial growth factor （VEGF） in serum of patients with diabetic microvascular complication and the severity of these complications and to find out a new method for early diagnosis and intervention of diabetic mierovascular complication. Method 106 patients of diabetes were divided into three groups as following according to the results of fundus fluorescein angiography （ FFA ） and urinary albumin excretion rate （ UAER ） ： （ 1 ） group A ： the patients without diabetic retinopathy and UAER 〈 20 mg/min; （2） group B： the patients with non-proliferation diabetic retinopathy and UAER 〈 20 mg/min ; （ 3 ） group C ： the patients with non-proliferation diabetic retinopathy and 20 mg/min 〉 UAER 〉 200μg/min. The VEGF concentration in serum was measured in the patients and the health volunteers （ group D）. Result The level of VEGF in group D was lower than group A; group A lower than group B; and group B lower than group C significantly. Conclusion The level of serum VEGF of diabetes patients is higher than that in healthy volunteers, it is higher in the patients with diabetic microvascular complication than that in the patients without diabetic microvascular complication, and it higher as the severity of diabetic microvaseular complication aggravate. VEGF plays an important role in predicting the diabetic microvascular complication occurrence and development.