玻璃体腔注射雷珠单抗治疗严重增生型糖尿病视网膜病变后玻璃体细胞因子的变化  

Concentration of the inflammatory cytokines in vitreous of severe proliferative diabetic retinopathy after intravitreal ranibizumab injection

作　　者：王友[1] 邓铂林[2] 黄健[3] 安刚[3] 

机构地区：[1] 四川省简阳市人民医院眼科 [2] 重庆医科大学附属第一医院眼科 [3]辽宁省锦州市中心医院眼科,121001

出　　处：《中华眼底病杂志》2014年第5期484-487,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的 观察严重增生型糖尿病视网膜病变（PDR）患者玻璃体腔注射雷珠单抗后玻璃体细胞因子的变化.方法 临床检查确诊的严重PDR患者80例80只眼纳入研究.依照非主动随机方法将患眼分为单纯玻璃体切割手术组（A组）、玻璃体腔注射雷珠单抗联合玻璃体切割手术组（B组）,均为40只眼.两组间性别（x^2 =0.05）、年龄（t=0.59）、糖尿病病程（t=0.36）、HbA1c（t=0.13）比较,差异无统计学意义（P＞0.05）.A组平均眼压,B组注药前、玻璃体切割手术前平均眼压比较,差异无统计学意义（F=0.81,P＞0.05）.A组患眼行玻璃体切割手术时抽取玻璃体液0.4ml.B组患眼玻璃体腔注射雷珠单抗0.05 ml（含雷珠单抗0.5 mg）;注药后7d行玻璃体切割手术,抽取玻璃体液0.4 ml.双抗体酶联免疫吸附试验（ELISA）法测定玻璃体血管内皮生长因子（VEGF）、白介素（IL）-6、IL-8、细胞间黏附分子-1（ICAM-1）、结缔组织生长因子（CTGF）浓度.结果 玻璃体VEGF、ICAM-1浓度B组分别为（10.70±3.60）、（224.64±90.32） pg/L,A组分别为（72.38±23.59）、（665.61±203.34） pg/L.两组玻璃体VEGF、ICAM-1浓度比较,差异有统计学意义（t=16.34、12.53,P＜0.001）;玻璃体IL-6、IL-8浓度B组分为（210.64±80.27）、（156.00±57.74） pg/L,A组分别为（45.78±33.82）、（41.07±13.82）pg/L.两组玻璃体IL-6、IL-8浓度比较,差异有统计学意义（t=11.97、12.24,P＜0.001）.A、B组玻璃体CTGF浓度比较,差异无统计学意义（t=1.39,P＞0.05）.B组CTGF/VEGF较A组升高,差异有统计学意义（t=14.75,P＜0.001）.结论玻璃体腔注射雷珠单抗1周后VEGF、ICAM-1明显下降;IL-6、IL-8明显升高;CTGF浓度无明显变化,但CTGF/VEGF明显升高.Objective To observe the concentration of the inflammatory cytokines in vitreous of severe proliferative diabetic retinopathy （PDR） after intravitreal ranibizumab injection （IVR）.Methods A total of 80 PDR patients （80 eyes） were enrolled in this study.The patients were randomly divided into vitrectomy group （group A） and IVR combined with vitrectomy group （group B）,40 eyes in each group.The differences of sex（x^2=0.05）,age （t=0.59）,duration of diabetes （t=0.36）,HbA1c （t=0.13） and intraocular pressure （F=0.81） between two groups were not significant （P〉0.05）.The eyes in group B received 0.5 mg （0.05 ml） ranibizumab injection at 7 days before operation.The vitreous samples （0.4 ml）were obtained before operation.The concentration of vascular endothelial growth factor （VEGF）,interleukin （IL）-6,IL-8,intercellular adhesion molecule-1 （ICAM-1） and connective tissue growth factor （CTGF） were measured by enzyme-linked immunosorbent assays.Results The concentration of VEGF and ICAM-1 were （10.70±3.60）,（224.64±90.32） pg/L in group B and （72.38±23.59）,（665.61±203.34）pg/L in group A.The differences of VEGF and ICAM-1 concentration between two groups was significant （t=16.34,12.53 ; P〈 0.001）.The concentration of IL-6 and IL-8 were （210.64±80.27）,（156.00±57.74） pg/L in group B and （45.78±33.82）,（41.07±13.82） pg/L in group A.The differences of IL-6 and IL-8 concentration between two groups was significant （t=11.97,12.24; P〈0.001）.There was no difference of CTGF concentration between two groups （t=1.39,P=0.17）.The CTGF/VEGF in group B was higher than that in group A （t=14.75,P〈0.001）.Conclusions One week after IVR,the concentration of VEGF and ICAM-1 are decreased,while IL-6 and IL-8 increased.There is no obvious change in CTGF,but CTGF/VEGF is increased.

关 键 词：糖尿病视网膜病变/治疗 血管生成抑制剂/治疗应用 抗体 单克隆/治疗应用 血管内皮生长因子类 炎症趋化因子类 

分 类 号：R774.1[医药卫生—眼科]