天津医药

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糖尿病视网膜增殖膜应用抗VEGF因子后组织病理学观察

胡博杰1,刘新玲2,李筱荣2,宋文静2   

  1. 1. 天津医科大学眼科中心
    2.
  • 收稿日期:2009-12-30 修回日期:2010-01-11 出版日期:2010-04-15 发布日期:2010-04-15
  • 通讯作者: 胡博杰

The histopathologic observation for diabetic retinopathy membrane after use anti-VEGF gene

  • Received:2009-12-30 Revised:2010-01-11 Published:2010-04-15 Online:2010-04-15
  • Contact: HU Bo Jie

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摘要： 目的:研究增殖性糖尿病视网膜病变玻璃体腔注射Avastin后增殖膜的组织病理学变化.方法:选择2008年1月-6月的糖尿病视网膜病变患者,随机分组,对照组直接行玻璃体切割术,实验组玻璃体腔注射抗VEGF因子（Avastin 1.25mg/0.05ml）后10天行玻璃体切割术,术中取增殖膜行组织病理学检查,采用HE染色方法,观察糖尿病视网膜增殖膜,新生血管, 血管内皮细胞, 原始组织细胞的变化.结果: 光镜下观察糖尿病视网膜增殖膜由胶原等细胞外基质以及不同形态的细胞构成的，新生血管散在分布。实验组的新生血管数目，血管内皮细胞和原始组织细胞数目均有下降,与对照组比较有统计学差异（P<0.05）。结论: 玻璃体腔注射抗VEGF因子可以抑制新生血管的形成, 使视网膜新生血管消退，减少术中和术后出血提高了手术的成功率,可作为治疗增殖性糖尿病视网膜病变的有效手段。

关键词: 糖尿病视网膜病变, 抗VEGF因子, 血管内皮细胞, 新生血管

Abstract: Purpose: To analyze the histopathologic change of proliferative membrane in patient with diabetic retinopathy after intravitreal injection of Avastin.Methods: The patients with diabetic retinopathy between January 2008 and June were divided into 2 groups randomly. Control groups recieved vitrectomy directly, but expermental groups recieved vitrectomy 10 days after intravitreal injection of Avastin（Avastin 1.25mg/0.05ml）. During surgery the proliferative membrane were peeled, and by HE staining method to observe the change of its new vessels, vascular endothelial cell, initial cell. Results: The diabetic retinopathy proliferative membrane are made up of extracellular matrix,different morphology cell and new vessels under light microscope. The difference of new vessels ,vascular endothelial cell, initial cell was statistical significant between the two groups (P<0.05). Conclusions: Intravitreal anti-VEGF gene is associated with a rapid regression of retinal neovascularization secondary to diabetic retinopathy,reduce hemorrhage and improve surgery success rates,it is an important adjunctive treatment in the management of diabetic retinopathy.

Key words: diabetic retinopathy, anti-VEGF gene, vascular endothelial cell, new vessels