血清血管生成抑制蛋白-1、血管内皮生长因子与2型糖尿病视网膜病变的相关性研究

Clinical study on the correlation between serum vasohibin-1 and vascular endothelial growth factor level and stage of type 2 diabetic retinopathy

目的探究血清血管生成抑制蛋白-1(VASH-1)、血管内皮生长因子(VEGF)与2型糖尿病视网膜病变的相关性。方法选择2019年7月—2020年6月在本院内分泌一科住院治疗的189患者作为研究对象,根据1999年WHO糖尿病诊断及分型标准、专业眼科医师行眼底检查和(或)荧光素血管造影(FFA)结果进行分组,其中2型糖尿病+无糖尿病(T2DM+NDR)组63例,2型糖尿病+非增殖期糖尿病视网膜病变(T2DM+NPDR)组63例,2型糖尿病+增殖期糖尿病视网膜病变(T2DM+PDR)组63例;另选取同时期常规体检健康组46名作为对照组。比较四组相关指标,如性别、体重指数(BMI)、糖尿病病程、血压、空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、糖化血红蛋白(HbA1c)、C肽(C-P)0分水平、空腹胰岛素水平(FINS)等。运用酶联免疫吸附法(ELISA)对四组受试者血清中VASH-1、VEGF水平进行测定并分析其相关性。结果血清中VEGF表达水平比较:T2DM+PDR组>T2DM+NPDR组>T2DM+NDR组>对照组,两两组间差异具有统计学意义(P<0.01);血清VASH-1表达水平比较:T2DM+PDR组>T2DM+NPDR组>T2DM+NDR组>对照组,两两组间差异具有统计学意义(P<0.01)。Pearson分析:四组受试者血清中VEGF、VASH-1表达水平均与2型糖尿病视网膜病变发展程度呈正相关,各组中VEGF、VASH-1表达水平呈正相关。结论VEGF、VASH-1水平随着2型糖尿病视网膜病变程度的加深表达水平逐渐升高,存在一定的差异性,在PDR期较为明显,提示两者在2型糖尿病视网膜病变早期阶段诊断及治疗有着重要的作用。

Objective To explore the expression of serum vasohibin-1(VASH-1)and vascular endothelial growth factor(VEGF)levels in each stage of patients with type 2 diabetic retinopathy and the correlation between them.Methods According to the WHO diabetes diagnosis and classification standard(1999),the results of fundus examination and(or)fundus fluorescein angiography(FFA)conducted by professional ophthalmologist,a total of 189 patients those admitted to the first ward of endocrinology of third affiliated hospital of Qiqihar Medical College from July 2019 to June 2020 were enrolled as study subjects.Among the patients,there were 63 cases in the type 2 diabetes+no history of diabetes retinopathy(T2DM+NDR)group,63 examples in type 2 diabetes mellitus+nonproliferative diabetes retinopathy(T2DM+NPDR)group,and 63 cases in type 2 diabetes mellitus+proliferative diabetes retinopathy(T2DM+PDR)group,and a total of 46 healthy subjects were selected as the control group.The related indexes of the four groups were compared,such as gender,body mass index(BMI),diabetes course,blood pressure,fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),glycosylated hemoglobin(HbA1c),c-peptide(C-P)0 points level,fasting insulin level(FINS),etc.Serum levels of VASH-1 and VEGF were measured and analyzed by enzyme linked immunosorbent assay(ELISA),and the correlation between them were analyzed.Results Comparison of serum VEGF expression levels:T2DM+PDR group>T2DM+NPDR group>T2DM+NDR group>control group,in which every two groups had statistical significance(P<0.01).Comparison of serum VASH-1 expression levels:T2DM+PDR group>T2DM+NPDR group>T2DM+NDR group>control group,the two groups had statistical significance(P<0.01).Pearson analysis:the expression levels of VEGF and VASH-1 in serum of the four groups were positively correlated with the development of type 2 diabetic retinopathy and the expression levels of VEGF and VASH-1 in each group were positively correlated.Conclusions The expression levels of VEGF and VASH-1 in serum of the four groups are positively correlated with the development of type 2 diabetic retinopathy,and there are certain differences,which are more obvious in PDR stage,suggesting that they play an important role in the early diagnosis and treatment of type 2 diabetic retinopathy.