糖尿病黄斑水肿患眼内界膜标本血管内皮生长因子和水通道蛋白4的表达

The expressions of vascular endothelial growth factor and aquaporin 4 in the inner limiting membrane from eyes with diabetic macular edema

目的观察糖尿病视网膜病变(DR)伴黄斑水肿患眼内界膜(ILM)中血管内皮生长因子(VEGF)和水通道蛋白4(AQP4)的表达,初步分析VEGF与AQP4表达量的相关性。方法横断面研究。2019年9月至2020年9月于温州医科大学附属眼视光医院杭州皖区接受玻璃体切割手术(PPV)联合ILM剥除治疗的DR和特发性黄斑裂孔(ІМН)患者38例38只眼纳人研究。其中,男性25例,女性13例;年龄37〜76岁,平均年龄(59±10)岁;右眼15只,左眼23只。ІМН、DR分别为9例9只眼和29例29只眼,并据此分为ІМН组、DR组。DR组根据是否伴糖尿病黄斑水肿(DME)再分为DME组、无DME组,分别为14、15只眼。将剥除的ILM组织铺片固定后行免疫荧光分析,获取AQP4、VEGF突光模式图片各一张,采用Image J软件测定VEGF、AQP4荧光强度值。组间标本中VEGF、AQP4免疫荧光值差异比较采用单因素方差分析;AQP4荧光强度值与VEGF荧光强度值之间的相关性采用Pearson相关性分析。结果DME组、无DME组、ІМН组ILM标本中平均VEGF、AQP4荧光强度值分别为38.96±7.53、28.25±3.12、30.07±4.84和49.07±8.73、37.96±6.45、38.08±5.04。DME组ILM标本中VEGF、AQP4平均荧光强度值显著高于无DME组、ІМН组,差异有统计学意义(F=13.977、9.454,P<0.05)。DR组IML标本中VEGF、AQP4平均荧光强度值分别为33.80±7.91、43.76±9.44。Pearson相关性分析结果显示,DRIEILM标本中VEGF与AQP4荧光强度值呈显著正相关(г=0.597,P=0.003)。结论DR伴DME患眼ILM中VEGF、AQP4表达较无DME者显著增加;DR患眼ILM中VEGF和AQP4表达呈正相关。

Objective To observe the expression of vascular endothelial growth factor(VEGF)and aquaporin 4(AQP4)in the inner limiting membrane(ILM)of diabetic retinopathy(DR)with macular edema,and analyze the correlation between VEGF and AQP4 expression.Methods A cross-sectional study.From September 2019 to September 2020,38 eyes of 38 patients with DR and idiopathic macular hole(ІМН)who underwent vitrectomy(PPV)combined with ILM stripping at the Hangzhou campus of The Affiliated Eye Hospital of Wenzhou Medical University at Hangzhou were included in the study.Among them,there were 25 males and 13 females who aged 37-76 years old,average age was 59d=10 years old;All eye included 15 right eyes and 23 left eyes.iMH and DR included 9 eyes in 9 cases and 29 eyes in 29 cases,respectively,and they were divided intoІМНgroup and DR group.The DR group was divided into DME group and no DME group according to whether it was accompanied by diabetic macular edema(DME),with 14 eyes and 15 eyes respectively.After the stripped ILM tissue was fixed,immunofluorescence analysis was performed to obtain a picture of the fluorescence mode of AQP4 and VEGF,and the fluorescence intensity value of VEGF and AQP4 was measured by Image J software.The differences of VEGF and AQP4 immunofluorescence values in the specimens between groups were compared by one-way analysis of variance.The correlation between the fluorescence intensity of AQP4 and the fluorescence intensity of VEGF was analyzed by Pearson correlation analysis.Results The average fluorescence intensity valuesof VEGF and AQP4 in ILM specimens of DME group,no DME group and iMH group were 38.96±7.53,28.25±3.12,30.07±4.84 and 49.07±8.73,37.96±6.45,38.08±5.04,respectively.The average fluorescence intensity of VEGF and AQP4 in the ILM specimens of the DME group was significantly higher than that of the no DME group and iMH group,and the difference was statistically significant(F=13.977,9.454;P<0.05).The average fluorescence intensity values of VEGF and AQP4 on IML specimens in the DR group were 33.80±7.91,43.76±9.44,respectively.The results of Pearson correlation analysis showed that the fluorescence intensity of VEGF and AQP4 in the ILM specimens of the DR group was significantly positively correlated(r=0.597,P=0.003).Conclusions The expressions of VEGF and AQP4 in ILM of eyes with DR and DME are significantly increased compared with those without DME.The expression of VEGF and AQP4 in ILM of eyes with DR is positively correlated.