不同时期糖尿病视网膜病变患者血管内皮祖细胞及玻璃体内MMP⁃9、VEGF的变化及意义  

Changes in vascular endothelial progenitor cells as well as matrix metallopro⁃teinase⁃9 and vascular endothelial growth factor in the vitreous fluid of pa⁃tients with diabetic retinopathy in different stages and their significance

作　　者：付馨余[1] 梅希[1] 李君艾 刘畅 FU Xinyu;MEI Xi;LI Junai;LIU Chang(Department of Ophthalmology,the First Affiliated Hospital of Chengdu Medical College,Chengdu 610050,Sichuan Province,China;Department of Basic Medicine Chengdu Medical College,Chengdu 610050,Sichuan Province,China)

机构地区：[1]成都医学院第一附属医院眼科,四川省成都市610050 [2]成都医学院基础医学院,四川省成都市610050

出　　处：《眼科新进展》2023年第5期375-378,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:81900725);四川省老年医学临床医学研究中心专项科学研究基金一般项目(编号:CYFY2021LNYB02)。

摘　　要：目的通过观察不同时期糖尿病视网膜病变(DR)患者外周血血管内皮祖细胞(EPCs)及玻璃体内基质金属蛋白酶(MMP⁃9)、血管内皮生长因子(VEGF)中的变化,探讨EPCs与MMP⁃9、VEGF在DR发病机制中的可能作用及意义。方法前瞻性研究。选择2020年1月至2021年12月在我院诊断为视网膜疾病不伴有糖尿病的患者35例35眼为空白对照组(A组),诊断为Ⅱ型糖尿病不伴有视网膜病变的患者37例37眼为单纯对照组(B组),选择同期我院诊断为DR的患者共78例78眼,按照DR诊断标准分为非增生型DR(NPDR,C组)36例和增生型DR(PDR,D组)42例,流式细胞仪测定并比较四组患者外周血中EPCs的数量变化,酶联免疫吸附实验(ELISA)测定并比较D组及A组患者玻璃体内MMP⁃9、VEGF的蛋白表达水平。结果四组患者EPCs数量差异有统计学意义(P=0.017)。A组、D组患者EPCs数量均显著高于B组、C组,差异均有统计学意义(均为P<0.05);与A组相比,D组患者EPCs数量略有增加,但两组间差异无统计学意义(P>0.05);B组与C组患者EPCs数量比较差异无统计学意义(P>0.05)。D组患者MMP⁃9、VEGF的蛋白表达水平明显高于A组,差异均有统计学意义(均为P<0.05),B组及C组患者未参与比较。结论糖尿病可引起外周血EPCs数量减少,但EPCs数在PDR时大量增加,并且与之相关的MMP⁃9、VEGF明显高表达,可能提示EPCs通过调节相关因子的表达参与糖尿病视网膜新生血管增殖的发生机制。Objective To observe the changes in the number of endothelial progenitor cells(EPCs)in the peripheral blood as well as matrix metalloproteinase⁃9(MMP⁃9)and vascular endothelial growth factor(VEGF)in the vitreous fluid of diabetic retinopathy(DR)patients at different stages and explore the possible role of EPCs,MMP⁃9 and VEGF in DR.Methods A prospective study was carried out.Totally 35 patients(35 eyes)diagnosed with retinal diseases and no dia⁃betes in our hospital from January 2020 to December 2021 were selected as the blank control group(group A),37 patients(37 eyes)diagnosed with Type 2 diabetes and no retinal diseases were selected as the simple control group(group B),and 78 patients(78 eyes)diagnosed with DR in our hospital in the same period were included and divided into the non⁃prolifer⁃ative DR group(NPDR,group C,n=36)and proliferative DR group(PDR,group D,n=42)according to the diagnostic criteria of DR.Flow cytometry was used to measure and compare the number of EPCs in peripheral blood of patients in the four groups,and the protein expressions of MMP⁃9 and VEGF in the vitreous fluid of patients in group D and group A were determined and compared by enzyme⁃linked immunosorbent assay.Results There was a significant difference in the number of EPCs in the four groups(P=0.017).The number of EPCs in group A and group D was significantly higher than that in group B and group C(all P<0.05).Compared with group A,the number of EPCs was slightly higher in group D,with no statistically significant difference(P>0.05).There was no significant difference in the number of EPCs in group B and group C(P>0.05).The protein expressions of MMP⁃9 and VEGF in group D were significantly higher than those in group A(both P<0.05),and no comparison was made between group B and group C.Conclusion Diabetes can induce the reduction of EPCs in peripheral blood,but EPCs increase significantly and levels of MMP⁃9 and VEGF increase signifi⁃cantly in PDR patients,suggesting that EPCs may be involved in the pathogen

关 键 词：糖尿病视网膜病变 血管内皮祖细胞 基质金属蛋白酶 血管内皮生长因子 

分 类 号：R774-1[医药卫生—眼科]