VEGF、ET、NO和AT-Ⅲ在糖尿病视网膜病变中的表达及相关性研究

The expression and correlation of VEGF, ET, NO and AT-Ⅲ in diabetic retinopathy

目的探究血管内皮生长因子(VEGF)、内皮素(ET)、一氧化氮(NO)和抗凝血酶Ⅲ(AT-Ⅲ)在糖尿病视网膜病变中的表达及相关性。方法选取2015年1月-2016年12月在新疆医科大学第一附属医院眼科及内分泌科住院治疗的糖尿病患者90例,同时选取同期在该院进行常规检查的健康人群30例作为健康对照组。按照眼底荧光素血管造影结果将糖尿病患者分为无视网膜病变组(NDR组)、非增殖期视网膜病变组(NPDR组)、增殖期视网膜病变组(PDR组)各30例。分别通过酶联免疫吸附法测定VEGF水平,放射免疫法测定ET水平,硝酸还原酶比色法测定NO水平,发光底物法测定AT-Ⅲ水平,对比4组VEGF、ET、NO、AT-Ⅲ水平以及4项指标对糖尿病视网膜病变(DR)的检验效能。结果 NDR组、NPDR组和PDR组患者的VEGF、ET、NO水平均明显高于健康对照组,NDPR组患者的AT-Ⅲ水平明显低于其他3组,PDR组与其他组相比AT-Ⅲ水平相对较高(P<0.05);VEGF在糖尿病视网膜病变检验与诊断中的敏感度、特异度等明显高于其他3项指标(P<0.05)。结论糖尿病视网膜病变在早期阶段,其血管内皮功能已经开始出现相应改变,血管内皮功能指标的水平与患者病情发展存在相关关系,其中VEGF和ET在糖尿病视网膜病变的早期诊断及进入增殖期视网膜病变时期中具有重要作用。

Objective To investigate the expression and correlation of vascular endothelial growth factor(VEGF),endothelin(ET),nitric oxide(NO)and antithrombinⅢ(AT-Ⅲ)in diabetic retinopathy.Methods90 patients with diabetes mellitus admitted to the department of ophthalmology and endocrinology,the First Affiliated Hospital of Xinjiang Medical University from January 2015 to December 2016 were enrolled.Meanwhile,30 healthy people who underwent routine examination in our hospital were selected as normal control group.According to fundus fluorescein angiography,diabetic patients were divided into no retinopathy group(NDR group),non-proliferative retinopathy group(NPDR group)and proliferative retinopathy group(PDR group).And 30 cases were segmented into each group.The level of VEGF and ET was respectively measured by enzyme linked immunosorbent assay and radioimmunoassay,and the level of NO and AT-Ⅲwas respectively analyzed by nitrate reductase colorimetry and luminescent substrate method.The efficacy of four groups of VEGF,ET,NO,AT-Ⅲand four indexes on diabetic retinopathy(DR)was compared.ResultsThe level of VEGF,ET and NO in NDR group,the NPDR group and PDR group were significantly higher than that of healthy controls.The level of AT-Ⅲin patients of NDPR group were significantly lower than the other three groups.The level of AT-Ⅲin patients of PDR group was relatively high compared with the other groups(P<0.05).The sensitivity and specificity of VEGF in the detection and diagnosis of diabetic retinopathy were significantly higher than the other three indicators(P<0.05).ConclusionIn the early stage of diabetic retinopathy,the vascular endothelial function has been accordingly changed,the index level of vascular endothelial function is correlated with the development of the patient′s condition.VEGF and ET play an important role in the early diagnosis of diabetic retinopathy and and the stage of proliferative retinopathy.