玻璃体腔注射抗血管内皮生长因子单克隆抗体bevacizumab对增生型糖尿病视网膜病变纤维血管膜中整合素链接激酶表达的影响

Effect of intravitreal injection with bevacizumab on expression of integrin-linked kinase in fibrovascular membranes of proliferative diabetic retinopathy

目的 观察玻璃体腔注射抗血管内皮生长因子单克隆抗体bevacizumab（商品名Avastin）对增生型糖尿病视网膜病变（PDR）纤维血管膜中整合素链接激酶（ILK）表达及视网膜血管内皮细胞数量的影响。方法玻璃体切割手术中取出的24例PDR患者的视网膜前纤维血管膜，其中12例患者手术前1周玻璃体腔单次注射bevacizumab1．25mg；另外12例未注射bevacizumab。苏木精一伊红（HE）染色、第Ⅷ因子相关抗原免疫组织化学染色后计数纤维血管膜内的血管内皮细胞数量，免疫组织化学染色检测膜内ILK蛋白表达量。结果免疫组织化学半定量检测显示，24个PDR纤维血管膜中均有ILK表达，使用和未使用bevacizumab组ILK表达量平均吸光度EA，旧称光密度（OD）]值分别为127．25士12．67和129．25±14．49，二者比较，差异无统计学意义（t=0．330，P=0．745）。使用bevacizumab组PDR纤维血管膜中血管内皮细胞数为（21．50±3．94）个，未使用bevacizumab组的血管内皮细胞数为（41．33±7．44）个，二者比较，差异有统计学意义（t=3．872，P=0．003）。结论PDR纤维血管膜中有ILK表达，提示ILK可能参与视网膜新生血管的形成过程；玻璃体腔注射bevacizumab，能够减少PDR视网膜新生血管内皮细胞数量，但不能下调ILK的表达。

Objective To observe the effect of intravitreal injection of bevacizumab （Avastin, IVB） on the expression of integrin-linked kinase （ILK） in fibrovascular membranes and the number of vascular endothelial cells （VECs） in proliferative diabetic retinopathy （PDR）. Methods Twenty-four fibrovascular membrane samples were collected during pars plana vitrectomy in 24 patients with PDR. 12 PDR patients had received a single 1.25 mg IVB 7 days preoperatively （bevacizumab group）, the other 12 patients （non- bevacizumab group） had not received IVB. For each of 24 fibrovascular membranes specimen, the number of VECs in the membranes were counted after staining with hematoxylin-eosin and von willebrand factor. Expressions of ILK in the fibrovascular membranes were detected through immunohistochemistry analysis. Results Immunohistochemistry revealed that ILK was highly expressed in all of 24 fibrovascular membranes of PDR. The average optical density of ILK expression level in bevacizumab and non-bevacizumab group were （127. 784±15.08） and （129. 034±16.26） respectively, the difference was not statistically significant （t=0.330, P = 0. 745）. The number of VECs in fibrovascular membranes in bevacizumab and non- bevacizumab group were 21.50 ±3.94 and 41.33 4± 7.44 respectively, the difference was statistically significant （t=3. 872,P= 0. 003）. Conclusions ILK was expressed in fibrovascular membranes of PDR. IVB can decrease the number of VECs during the process of PDR, but it can not affect the expression of ILK protein.