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目的:探讨血清血管内皮细胞生长因子(VEGF)、内皮抑素(ES)、血小板反应蛋白(TSP)、组织激肽释放酶(TKLK)及可溶性细胞间黏附分子-1(s ICAM-1)水平在糖尿病视网膜病变(DR)患者血清中的变化及其临床意义。方法:选取我院2014-01/2016-12收集的无眼底病变的糖尿病患者60例(DM组)、非增殖性糖尿病视网膜病变患者60例(NPDR组)、增殖性糖尿病视网膜病变患者60例(PDR组)和同期健康体检对象60例(对照组),检测四组患者血清VEGF、ES、TSP、TKLK、s ICAM-1水平并进行比较分析。结果:PDR组患者的血清VEGF、TKLK、s ICAM-1水平均显著高于NPDR组、DM组、对照组(P<0.05);PDR组患者的血清ES水平均显著低于NPDR组、DM组、对照组(P<0.05)。NPDR组患者的血清VEGF、TKLK、ES水平均显著高于DM组和对照组(P<0.05)。NPDR组患者的血清VEGF与ES、TKLK、s ICAM-1水平均呈显著的正相关关系(P<0.05)。PDR组患者的血清VEGF与TKLK、s ICAM-1水平均呈显著的正相关关系(P<0.05),PDR组患者的血清VEGF与ES、TSP相关性不显著(P>0.05)。结论:DR患者血清ES、TSP、TKLK、s ICAM-1水平均发生显著改变,通过调节VEGF水平影响DR进程。
Objective: To investigate the expression of serum vascular endothelial growth factor (VEGF), endostatin (ES), thrombospondin (TSP), tissue kallikrein (TKLK) and soluble intercellular adhesion molecule-1 In the serum of patients with diabetic retinopathy (DR) and its clinical significance. Methods: Sixty diabetic patients without diabetic retinopathy (DM group), 60 patients with non-proliferative diabetic retinopathy (NPDR group), 60 patients with proliferative diabetic retinopathy (60 patients with diabetic retinopathy) were enrolled in our hospital from January 2014 to December 2016 PDR group) and 60 healthy subjects at the same period (control group). The serum levels of VEGF, ES, TSP, TKLK and s ICAM-1 in the four groups were detected and compared. Results: Serum levels of VEGF, TKLK and s ICAM-1 in PDR group were significantly higher than those in NPDR group, DM group and control group (P <0.05). Serum ES levels in PDR group were significantly lower than those in NPDR group and DM group , Control group (P <0.05). The levels of serum VEGF, TKLK and ES in patients with NPDR were significantly higher than those in DM and control groups (P <0.05). There was a significant positive correlation between serum VEGF and ES, TKLK, sICAM-1 levels in patients with NPDR (P <0.05). There was a significant positive correlation between serum VEGF and TKLK, s ICAM-1 levels in patients with PDR (P <0.05). There was no significant correlation between serum VEGF and TSP in patients with PDR (P> 0.05). Conclusion: Serum levels of ES, TSP, TKLK and s ICAM-1 in patients with DR are significantly changed, and the level of VEGF is affected by DR.