CAJ | 학술논문

目的：探讨糖尿病视网膜病变（ diabetic retinopathy， DR）患者血管内皮生长因子（ vascular endothelial growth factor， VEGF）水平与微血管损伤程度的相关性。 　　方法：回顾性分析本院收治的糖尿病患者71例，根据有无DR及病变程度分为三组：单纯糖尿病组（ n＝31）、单纯型DR组（ n＝22）、增殖型DR组（ n＝18），比较各组微血管病变发生率。同时，取患者空腹肘静脉血，采用ELISA试剂盒测定血清VEGF水平，采用流式细胞仪检测内皮细胞（ ECs）、内皮祖细胞（ EPCs）、循环祖细胞（ CPCs）计数。 　　结果：各组糖尿病肾病和糖尿病神经病变发生率有明显差异，增殖型DR组高于单纯型DR组和单纯糖尿病组，差异有统计学意义（ P＜0．05）。各组VEGF水平有明显差异，增殖型DR组高于单纯型DR组和单纯糖尿病组，单纯型DR组高于单纯糖尿病组；合并糖尿病肾病及糖尿病神经病变者VEGF水平高于非合并者，差异均有统计学意义（ P＜0．05）。各组之间ECs、EPCs、CPCs水平有明显差异，增殖型DR组ECs高于单纯型DR组和单纯糖尿病组，单纯型DR组高于单纯糖尿病组；增殖型DR组EPCs、CPCs水平低于单纯型DR组和单纯糖尿病组，单纯型DR组低于单纯糖尿病组，差异有统计学意义（P＜0．01）。增殖型DR患者的VEGF水平与ECs水平呈正相关性（ P＜0．01），与EPCs、CPCs水平呈负相关性（ P＜0．01）。 　　结论：VEGF在糖尿病视网膜病变，尤其是增殖型糖尿病视网膜病变的临床诊断和医疗中，有重要意义。
목적：탐토당뇨병시망막병변（ diabetic retinopathy， DR）환자혈관내피생장인자（ vascular endothelial growth factor， VEGF）수평여미혈관손상정도적상관성。 　　방법：회고성분석본원수치적당뇨병환자71례，근거유무DR급병변정도분위삼조：단순당뇨병조（ n＝31）、단순형DR조（ n＝22）、증식형DR조（ n＝18），비교각조미혈관병변발생솔。동시，취환자공복주정맥혈，채용ELISA시제합측정혈청VEGF수평，채용류식세포의검측내피세포（ ECs）、내피조세포（ EPCs）、순배조세포（ CPCs）계수。 　　결과：각조당뇨병신병화당뇨병신경병변발생솔유명현차이，증식형DR조고우단순형DR조화단순당뇨병조，차이유통계학의의（ P＜0．05）。각조VEGF수평유명현차이，증식형DR조고우단순형DR조화단순당뇨병조，단순형DR조고우단순당뇨병조；합병당뇨병신병급당뇨병신경병변자VEGF수평고우비합병자，차이균유통계학의의（ P＜0．05）。각조지간ECs、EPCs、CPCs수평유명현차이，증식형DR조ECs고우단순형DR조화단순당뇨병조，단순형DR조고우단순당뇨병조；증식형DR조EPCs、CPCs수평저우단순형DR조화단순당뇨병조，단순형DR조저우단순당뇨병조，차이유통계학의의（P＜0．01）。증식형DR환자적VEGF수평여ECs수평정정상관성（ P＜0．01），여EPCs、CPCs수평정부상관성（ P＜0．01）。 　　결론：VEGF재당뇨병시망막병변，우기시증식형당뇨병시망막병변적림상진단화의료중，유중요의의。
?AIM:To explore the correlation of vascular endothelial growth factor ( VEGF ) level and microvascular damage degree in patients with proliferative diabetic retinopathy ( DR) . ?METHODS:Seventy-one patients with diabetes were analyzed retrospectively, and divided into 3 groups according to the degree of DR:the pure diabetes group ( n=31), the pure DR group (n=22) and the proliferative DR group ( n=18 ) .The incidence of microvascular damage was compared;At the same time, fasting venous blood of patients was extracted, and the VEGF levels were detected with ELISA kits, the endothelial cells ( ECs ) , endothelial progenitor cells ( EPCs ) and circulating progenitor cells ( CPCs ) counts were detected with flow cytometry. ?RESULTS:The incidence of diabetic nephropathy and diabetic neuropathy was significantly different in three groups, proliferative DR group was higher than pure DR group and pure diabetes group, the difference was statistically significant (P<0.05).There was difference in VEGF levels among groups, the proliferative DR group was higher than the pure DR group the pure diabetes group, and the pure DR group was higher than the pure diabetes group (P<0.05,P<0.01).VEGF levels in patients complicated with diabetic nephropathy and diabetic neuropathy were higher than the non -complicated patients, the differences were statistically significant ( P<0.05).There was significant difference in ECs, EPCs and CPCs among groups, the ECs of proliferative DR group was higher than that of the pure DR group the pure diabetes group, and that of the pure DR group was higher than that of the pure diabetes group (P<0.01), but EPCs and CPCs reversed. The VEGF level had positively correlation with ECs level (P<0.01), and had negatively correlation with EPCs and CPCs levels ( P <0.01 ) in patients with proliferative DR. ?CONCLUSION:VEGF has important significance in the clinical diagnosis and medical treatment of diabetic retinopathy, especially proliferative diabetic retinopathy.