各期糖尿病视网膜病变患者房水中PEDF与OPs的相关性分析

Abstract

目的：探讨房水中色素上皮衍生因子(pigment epithelium derived factor, PEDF)与视网膜电图振荡电位(oscillatory potentials, OPs)在各期糖尿病性视网膜病变中的相关性研究分析，为糖尿病视网膜病变(diabetic retinopathy, DR)的早期诊断及病程进展预测提供客观的检测依据。方法：房水来自2型糖尿病患者40例40眼。单纯2型糖尿病患者组19例19只眼，非增殖期糖尿病性视网膜病变(non-proliferative diabetic retinopathy, NPDR)组患者11例11只眼，增殖期糖尿病视网膜病变(proliferative diabetic retinopathy, PDR)组患者10例10只眼，单纯老年性白内障患者20例20只眼作为对照组。用酶联免疫吸附法检測房水中PEDF的水平，用德国 ROLAND CONSULT公司生产的罗兰视觉电生理检查仪检测全视网膜电图中OPs的总振幅值。结果：单纯2型糖尿病患者组、NPDR组及PDR组的房水中PEDF的浓度分别为(9.13 ± 4.43) ng/ml、(7.00 ± 2.04) ng/ml、(6.39 ± 1.66) ng/ml与对照组(13.87 ± 0.36) ng/ml相比，房水中PEDF浓度均明显降低(P < 0.01)，单纯2型糖尿病患者组与NPDR组及PDR组相比，房水中PEDF浓度亦均明显降低(P = 0.04, P = 0.02)，而NPDR组与PDR组相比无明显差异(P = 0.34)；单纯2型糖尿病患者组、NPDR组及PDR组的OPs的总振幅值分别为(164.56 ± 37.41) μV、(79.80 ± 19.89) μV、(28.55 ± 17.47) μV与对照组(237.96 ± 35.96) μV相比，OPs的总振幅值均明显降低(P < 0.01)，而且组间两两比较亦有明显差异(P < 0.01)；各期糖尿病性视网膜病变房水中PEDF浓度变化与OPs的总振幅值呈典型的正相关(r = 0.905, P < 0.01)。结论：房水中PEDF的浓度与OPs总波幅在各期糖尿病性视网膜病变中呈正相关，可为糖尿病视网膜病变的早期诊断及病程进展预测提供客观的检测依据。 Objective: To investigate the relationship between pigment epithelium derived factor (PEDF) and oscillatory potentials (OPs) in various diabetic retinopathy and to provide an objective basis for the early diagnosis of diabetic retinopathy (diabetic retinopathy, DR) and the prediction of the progression of the disease. Methods: Aqueous humor samples were collected from 40 eyes of 40 type 2 diabetes patients, including 19 eyes without diabetic retinopathy and 21 eyes with diabetic (11 eyes with NPDR and 10 eyes with PDR), twenty aqueous samples from 20 cataract patients without other ocular or systemic diseases served as controls. The PEDF levels in aqueous humor were measured by enzyme-linked immunosorbent assay (ELISA). The total amplitude of OPs in the whole retina was detected by the Roland visual electrophysiological test instrument of the German CONSULT ROLAND company. Results: The PEDF and OPs level in eyes without diabetic retinopathy [(9.13 ± 4.43) ng/ml, 164.56 ± 37.41) μV, P < 0.01] was significantly lower than that in controls [(13.87 ± 0.36) ng/ml, (237.96 ± 35.96) μV]; the PEDF Ievel in eyes with NPDR [(7.00 ± 2.04) ng/ml, (79.80 ± 19.89) μV, P < 0.01] and PDR [(6.39 ± 1.66) ng/ml, (28.55 ± 17.47) μV, P < 0.01] was sig-nificantly lower than that in controls [(13.87 ± 0.36) ng/ml, (237.96 ± 35.96) μV]; the concentration of PEDF in the patients with type 2 diabetes mellitus was significantly lower than that in the NPDR and PDR group (P = 0.04, P = 0.02), while there was no significant difference between NPDR group and PDR group (P = 0.34). There were significant differences in different OPs group (P < 0.01). The PEDF concentration in the aqueous humor of the diabetic retinopathy was a typical positive correlation with the total amplitude of OPs (r = 0.905, P < 0.01). Conclusion: The concentration of PEDF in aqueous humor and the total amplitude of OPs were positively correlated with the diabetic retinopathy, which could provide an objective basis for the early diagnosis of diabetic retinopathy and the prediction of the progression of the disease.