The kinetics of VEGF and MCP-1 in the second vitrectomy cases with proliferative diabetic retinopathy
The kinetics of VEGF and MCP-1 in the second vitrectomy cases with proliferative diabetic retinopathy
复制标题
作者：
Sassa, Y.;Yoshida, S.;Kono, T.
目的探讨增殖性糖尿病视网膜病变(PDR)患者玻璃体切割术后玻璃体中血管内皮生长因子(VEGF)和单核细胞趋化蛋白-1(MCP-1)浓度的变化。二次手术的原因为牵拉性视网膜脱离(TRD)、新生血管性青光眼、持续性玻璃体出血、黄斑皱褶和二期人工晶状体植入。方法采用双抗体夹心酶联免疫吸附试验检测PDR患者玻璃体切除术前(未植入人工晶状体)和二次手术患者玻璃体标本中VEGF和MCP-1的水平。结果第一次手术和第二次手术的平均VEGF水平(0.81+/-0.88 ng/ml)和第二次手术(1.09+/-1.51 ng/ml)比较差异无统计学意义。第二次手术时MCP-1水平(2.20+/-2.21 ng/ml)显著高于第一次玻璃体手术(0.72+/-0.57 ng/ml)。二次手术后TRD患者血清MCP-1水平(3.18+/-2.27 ng/ml)明显高于其他并发症患者(1.72+/-2.10 ng/ml)。MCP-1浓度在第二次玻璃体切割术时显著升高，提示玻璃体切割术后炎症延长与并发症，特别是TRD之间存在关联。
Purpose To determine whether the concentrations of vascular endothelial growth factor (VEGF) and monocyte chemoattractant protein (MCP)-1 in the vitreous changed after vitrectomy in patients with proliferative diabetic retinopathy (PDR).Participants Twenty-one eyes of 21 patients who needed a second surgery for PDR were included. The reasons for the second surgery were tractional retinal detachment (TRD), neovascular glaucoma, persistent vitreous hemorrhage, macular pucker, and secondary intraocular lens (IOL) implant. Methods We measured the VEGF and MCP-1 levels using sandwich enzyme-linked immunosorbent assays in vitreous samples collected from patients with PDR before pars plana vitrectomy (without IOL implantation), and from the same patients during the second surgery.Results There was not significant change in mean VEGF concentrations when comparing first (0.81 +/- 0.88 ng/ml) and second surgeries (1.09 +/- 1.51 ng/ml). The MCP-1 level was significantly elevated at the time of second surgery (2.20 +/- 2.21 ng/ml) compared with the first vitrectomy (0.72 +/- 0.57 ng/ml). The MCP-1 levels of the second surgery cases with TRD (3.18 +/- 2.27 ng/ml) increased significantly compared with those with other complications (1.72 +/- 2.10 ng/ml).Conclusions At the second vitrectomy, VEGF did not change significantly in the vitreous of the patients examined. The MCP-1 concentration was markedly elevated at the second vitrectomy, implying an association between the prolonged inflammation after vitrectomy and complications, especially TRD.