PDR 患者血浆及眼内组织 VEGF 的表达与 t-PA 及 PAI 表达的相关性研究

摘要

目的：探讨增生性糖尿病视网膜病变（ PDR）患者血浆、房水VEGF的表达与组织纤溶酶原激活物（ t-PA）及纤溶酶原激活物抑制剂（ PAI）的表达及其相关性。方法实验研究。采用双抗体夹心酶联免疫吸附试验ELISA法定量检测来自宁夏医科大学总医院眼科的病例组（40例）及对照组（40例）患者血浆、房水、玻璃体中VEGF、t-PA、PAI的含量，通过秩和检验及Spearman相关性分析观察两组间差异及两变量的关联性。结果病例组血浆中VEGF（53.37 ng/L）、PAI（8.00μg/L）的表达浓度高于对照组，差异具有统计学意义（Z＝-3.437，-5.816；P＜0.01），病例组血浆中t-PA的表达浓度（24.32μg/L）与对照组比较无统计学意义（Z＝-1.715，P＝0.086），病例组房水中VEGF （335.00 ng/L）、t-PA（5.70μg/L）、PAI（0.63μg/L）的表达浓度高于对照组房水，差异具有统计学意义（Z ＝-4.805，-1.967，-4.018；P ＜0.05），病例组玻璃体中 VEGF （691.69 ng/L）、t-PA （13.05μg/L）、PAI（4.01μg/L）的表达浓度高于对照组玻璃体，差异具有统计学意义（ Z＝-2.807，-2.642，-2.230；P＜0.05）。病例组自身血浆、房水、玻璃体三者比较，VEGF浓度：玻璃体＞房水＞血浆；t-PA浓度：血浆＞玻璃体＞房水；PAI浓度：血浆、玻璃体＞房水。病例组血浆中VEGF与t-PA （r＝0.659）和PAI（r＝0.705）的表达均显著相关（P均＜0.01）；房水中VEGF与t-PA（r＝0.527）和PAI（ r＝0.648）的表达均显著相关（ P均＜0.01）；玻璃体中VEGF 与t-PA （ r＝0.798）和PAI （ r＝0.694）的表达均显著相关（P均＜0.01）。结论结论 PDR患者血浆中VEGF、PAI，房水、玻璃体中VEGF、t-PA、PAI的含量升高。血浆、房水、玻璃体中VEGF与t-PA、PAI均呈正相关。（中华眼科杂志，2014，50：448-453）%Objective To evaluate the correlation between the expression of VEGF with t-PA and PAI expression in plasma aqueous humor and vitreous of proliferative diabetic retinopathy ( PDR).Methods It was an experimental study.The concentrations of VEGF t-PA and PAI in plasma, aqueous humor and vitreous body in PDR and normal group were detected by ELISA.Results The levels of VEGF (53.37 ng/L) and PAI (8.00 μg/L) in the plasma of PDR patients were higher than control group ,and there was significant statistically difference between them (Z=-3.437,-5.816;P<0.01).The levels of t-PA (24.32 μg/L) in plasma of PDR patients and control group was no statistically difference between them(Z=-1.715,P=0.086).The levels of VEGF (335.00 ng/L) t-PA (5.70 μg/L) and PAI (0.63μg/L) in the aqueous humor of PDR patients were higher than control group , and there was statistically difference between them (Z=-4.805,-1.967,-4.018;P<0.05).The levels of VEGF (691.69 ng/L) t-PA (13.05 μg/L) and PAI (4.01μg/L) in the vitreous of PDR patients were higher than control group , and there was statistically difference between them (Z=-2.807,-2.642,-2.230;P<0.05).Compare the plasma aqueous humor and vitreous of PDR patients.The levels of VEGF is:vitreous>aqueous humor >plasma.The levels of t-PA is:plasma>vitreous>aqueous humor.The levels of PAI is:plasma and vitreous >aqueous humor.The expression of VEGF was highly correlated with t-PA and PAI in plasma aqueous humor and vitreous of PDR (P<0.05).Conclusions VEGF PAI in plasma, VEGF t-PA PAI in aqueous humor and vitreous were increases .The expression of VEGF was positive correlated with t-PA and PAI in plasma aqueous humor and vitreous of PDR .