摘要
目的探讨口服滋肾健脾化瘀片联合玻璃体腔注射康柏西普(IVC)治疗对糖尿病视网膜病变(DR)患者房水中细胞因子的影响。方法采用真实世界前瞻性研究。纳入2019年3月—12月在广州中医药大学第一附属医院眼科接受口服滋肾健脾化瘀片联合IVC治疗的DR患者32例(42只眼)作为观察组(DR组),在IVC术中抽取房水;纳入同期住院行白内障手术的患者27例(31只眼)作为对照组,在白内障手术中抽取房水。通过Luminex法检测2组患者房水中VEGF家族(VEGF-A、PLGF),PDGF家族(PDGF-AA、PDGF-BB),ANGPTL4,炎症因子(IL-1β、IL-6、IL-8、MCP-1、ICAM-1、TNF-α)等11种细胞因子表达。8周后,DR组行IVC术时再次抽取房水,比较DR组治疗前后房水中细胞因子表达的差异。结果(1)与对照组比较:DR组治疗前VEGF-A、PLGF、PDGF-AA、ANGPTL4、IL-6、IL-8、MCP-1、ICAM-1、TNF-α水平均高于对照组(Z_(VEGF-A)=-4.553,Z_(PLGF)=-3.588,Z_(PDGF-AA)=-4.464,Z_(ANGPTL4)=-7.265,Z_(IL-6)=-4.488,Z_(IL-8)=-5.770,Z_(MCP-1)=-5.100,Z_(ICAM-1)=-3.625,均P=0.000;Z_(TNF-α)=1.995,P=0.046),而IL-1β水平低于对照组(Z=-3.167,P=0.002);(2)DR组治疗前后比较:治疗后,DR组房水中细胞因子VEGF-A水平低于治疗前(Z=-5.608,P=0.000),IL-8浓度高于治疗前(Z=-2.907,P=0.004),而其余细胞因子治疗前后比较,差异均无统计学意义(均P>0.05)。结论DR的发生、发展可能与细胞因子中的VEGF家族、PDGF家族、ANGPTL家族及炎症因子相关;口服滋肾健脾化瘀片联合抗VEGF治疗能够在一定程度上使DR患者房水中VEGF-A水平降低,为该病的中西医结合治疗提供了一定依据。
OBJECTIVE To investigate the effect of oral Zishen Jianpi Huayu Tablets combined with intravitreal injection of Conbercept(IVC)on the cytokines in aqueous humor of patients with diabetic retinopathy(DR).METHODS The method of real-world prospective research is adopted.From March 2019 to December 2019,a total of thirty-two DR patients(forty-two eyes)who received oral Zishen Jianpi Huayu Tablets combined with IVC in the Department of Ophthalmology of the First Affiliated Hospital of Guangzhou University of Chinese Medicine were included as the observation group(DR group),and aqueous humor was extracted during IVC surgery.A total of twenty-seven patients(thirty-one eyes)hospitalized for cataract surgery during the same period were included as the control group,and aqueous humor was extracted during cataract surgery.Luminex method was used to detect the expression of eleven kinds of cytokines including VEGF family(VEGF-A,PLGF),PDGF family(PDGF-AA,PDGF-BB),ANGPTL4,and inflammatory factors(IL-1β,IL-6,IL-8,MCP-1,ICAM-1,TNF-α).After eight weeks,aqueous humor was extracted again during IVC surgery in DR group,and the expression difference of cytokines in aqueous humor of DR group between before and after the treatment were compared.RESULTS(1)Comparison between DR group and control group:When compared with the control group before treatment,the DR group had higher concentrations of VEGF-A,PLGF,PDGF-AA,ANGPTL4,IL-6,IL-8,MCP-1,ICAM-1,and TNF-α(Z_(VEGF-A)=-4.553,Z_(PLGF)=-3.588,Z_(PDGF-AA)=-4.464,Z_(ANGPTL4)=-7.265,Z_(IL-6)=-4.488,Z_(IL-8)=-5.770,Z_(MCP-1)=-5.100,Z_(ICAM-1)=-3.625,all P=0.000;Z_(TNF-α)=1.995,P=0.046),while the level of IL-1βwas lower(Z=-3.167,P=0.002).(2)Comparison between two operations:After treatment,the level of VEGF-A in aqueous humor of the DR group was lower than that before treatment(Z=-5.608,P=0.000),and level of IL-8 was higher than before treatment(Z=-2.907,P=0.004),while there was no significant difference in other aqueous humor cytokines before and after treatment(all P>0.05).CONCLUSIONS The
作者
滕月
曾筱婷
罗英子
刘红
阳艳
关国华
俞晓艺
TENG Yue;ZENG Xiaoting;LUO Yingzi;LIU Hong;YANG Yan;GUAN Guohua;YU Xiaoyi(First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)
出处
《中国中医眼科杂志》
2022年第10期767-772,共6页
China Journal of Chinese Ophthalmology
基金
国家中医药管理局中医药循证能力建设项目(2019XZZX-YK003)
全国名老中医药专家关国华传承工作室[国中医药人教教育便函(2018)74号]
广东省中医药局科研项目(20172048)。
