糖尿病视网膜病变细胞因子及视网膜血流变化的意义

Study on the change of cytokines and retinal blood flow index for patients with diabetic retinopathy

目的:探讨VEGF、细胞因子及视网膜血流状态与糖尿病视网膜病变(DR)的相关性。方法:将174例糖尿病患者根据视网膜病变情况分为无DR组(NDR,41例)、背景DR(NPDR,68例)及增殖期DR组(PDR,65例)三组,纳入健康志愿者30例作为对照组。对所有受试者血清VEGF、肿瘤坏死因子-α(TNF-α)、可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)及碱性成纤维细胞生长因子(bFGF)水平进行测定,并对其进行眼部彩色多普勒超声检查,测量视网膜中央动脉的各项血流动力学参数。结果:糖尿病患者血清VEGF,TNF-α,sICAM-1,sVCAM-1,bFGF水平显著高于对照组;PDR血清VEGF,TNF-α,sICAM-1,sVCAM-1,bFGF水平显著高于NDR和NPDR组,NPDR组血清VEGF,TNF-α,sICAM-1,sVCAM-1,bFGF水平又显著高于NDR(P<0.05)。糖尿病患者Vmax,Vmin,Vmean和PI显著低于对照组,RI显著高于对照组;PDR组Vmax,Vmin,Vmean和PI显著低于NDR和NPDR组,RI显著高于NDR和NPDR组;NPDR组Vmax,Vmin,Vmean和PI又显著低于NDR,RI则显著低于NDR和NPDR组(P<0.05)。结论:VEGF,TNF-α,sICAM-1,sVCAM-1,bFGF以及CRA血流动力学改变与DR的发生发展密切相关,在DR诊断和治疗中具有参考意义。

AIM： To investigate the relevance of serum levels of vascular endothelial growth factor （VEGF）, cytokines and retinal blood flow index to patients with diabetic retinopathy （DR）. METHODS： In this study, 174 cases of patients with diabetic were divided into three groups according to the retinal lesions, no DR group （NDR, 41 cases ）, background DR （NPDR, 68 cases） and proliferative DR group （PDR, 65 cases）, and 30 healthy volunteers were included as control group. The serum levels of VEGF, TNF-α, slCAM-1, sVCAM-1, bFGF of all the subjects were detected and compared, and the hemodynamic parameters of the central retinal artery were measured by doppler ultrasonography. RESULTS：The serum levels of VEGF, TNF-a, slCAM-1, sVCAM-1, bFGF of patients with diabetic were all higher than control group, and these index of PDR were higher than NDR and NPDR, while these index of NPDR were higher than NDR （P〈0.05）. The Vmax, Vmin, Vmean and PI of patients with diabetic were all lower than control group, RI was higher than control group; and the Vmax, Vmin, Vmean and PI of PDR were lower than NDR and NPDR, RI was higher than NDR and NPDR; while the Vmax, Vmin, Vmean and PI of NPDR were lower than NDR, RI was higher than NDR （P〈0.05）. CONCLUSION.The changes of serum levels of VEGF, TNF-α, slCAM-1, sVCAM-1, bFGF and hemodynamics of CRA are closely related to the occurrence and development of DR, and these indexes have a good reference significance in the diagnosis and treatment of DR.