NVG患者房水和血清中VEGF-A和PDGF及PEDF的临床意义

Comparison of VEGF-A,PDGF and PEDF levels in aqueous humor and serum of patients with neovascular glaucoma

目的:检测新生血管性青光眼(NVG)患者房水和血清中血管内皮生长因子-A(VEGF-A)、血小板源性生长因子(PDGF)、色素上皮衍生因子(PEDF)的含量,并分析其意义。方法:前瞻性临床研究。采用酶联免疫吸附法(ELISA)检测2015-12/2016-12在西京医院眼科住院的NVG患者23例及年龄相关性白内障患者23例房水及血清中VEGF-A、PDGF、PEDF的含量并定量分析。结果:NVG患者房水中VEGF-A、PDGF的含量分别为1130.56±69.32、221.95±56.08ng/L,均显著高于年龄相关性白内障患者组(226.45±37.46、36.25±7.12ng/L)(均P<0.01);NVG患者房水中PEDF的含量为195.69±42.00ng/L,低于年龄相关性白内障患者组(497.89±12.52ng/L)(P<0.01);NVG组血清中VEGF-A、PDGF及PEDF的含量分别为226.45±37.46、29.57±6.31及13.24±1.76ng/L,均与年龄相关性白内障患者组(219±34.89、28.28±7.24、12.96±2.08ng/L)无差异(均P>0.05)。NVG患者房水中VEGF-A和PDGF含量呈正相关(r=0.502,P=0.015),而VEGF-A与PEDF含量呈负相关(r=-0.480,P=0.020)。结论:NVG患者房水中VEGF-A、PDGF的含量显著升高,而PEDF的含量显著降低,且VEGF-A的含量与PDGF含量呈正相关、与PEDF含量呈负相关。联合使用VEGF-A、PDGF抑制剂及PEDF可能为NVG治疗提供新的思路。

AIM:To quantitatively measure and evaluate the VEGF-A,platelet derived growth factor(PDGF)and pigment epithelium derired factor(PEDF)in the aqueous humor of patients with neovascular glaucoma(NVG).METHODS:Prospectively clinical study.This study involved 23 eyes of 23 patients with advanced NVG and 23 control subjects with age related cataract.Protein concentrations of VEGF-A,PDGF and PEDF in aqueous humor and plasma were determined by enzyme-linked immunosorbent assay(ELISA)tests.RESULTS:The VEGF-A and PDGF concentrations in aqueous humor from NVG patients were(1130.56±69.32)ng/L and(221.95±56.08)ng/L,respectively.Both of them were significantly higher than control subject(226.45±37.46)ng/L,(36.25±7.12)ng/L(P<0.01).Aqueous PEDF was significantly lower in the NVG group(195.69±42.00)ng/L than that in controls(497.89±12.52)ng/L(P<0.01).However,levels of VEGF-A,PDGF and PEDF in the serum of NVG were(226.45±37.46)ng/L,(29.57±6.31)ng/L and(13.24±1.76)ng/L,respectively,which were similar with control subjects(219±34.89)ng/L,(28.28±7.24)ng/L and(12.96±2.08)ng/L(P>0.05).The concentrations of VEGF-A were closely positive correlated with levels of PDGF in the aqueous humor of patients with NVG(r=0.502,P=0.015).However,the concentrations of VEGF-A were closely negative correlated with levels of PEDF in the aqueous humor of patients with NVG(r=-0.480,P=0.020).CONCLUSION:There were higher levels of VEGF-A and PDGF,and lower level of PEDF in the aqueous humor of patients with NVG.There was a positive correlation between VEGF-A and PDGF,a negative correlation between VEGF-A and PEDF.The combination of anti-VEGF agent,PDGF inhibitor and PEDF may provide a new idea for the treatment of NVG.