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目的探讨脑红蛋白(NGB)在增殖性糖尿病视网膜病变(PDR)患者房水、玻璃体、视网膜前纤维增殖膜以及血清中的表达情况。设计临床病例对照研究。研究对象山西省眼科医院顺序就诊并确诊为PDR患者30例,其中Ⅳ、Ⅴ、Ⅵ期患者各10例,特发性黄斑裂孔(IMH)患者10例作为对照。方法通过玻璃体切除手术收集患者的房水、玻璃体、视网膜前纤维增殖膜(PDR组)或内界膜(IMH组)。术前抽静脉血离心取血清。运用ELISA方法定量检测PDR各组患者及IMH患者房水、玻璃体及血清中NGB的表达量。免疫组织化学染色法观察视网膜前纤维增殖膜及内界膜中NGB的表达。各组患者房水、玻璃体、血清中NGB表达量以及视网膜前纤维增殖膜、内界膜中NGB表达阳性率的总体差异比较均采用单因素方差分析,组间多重比较采用LSD-t检验。主要指标血清、房水、玻璃体、视网膜前纤维增殖膜(PDR组)及内界膜(IMH组)中NGB的表达量。结果 PDR各组血清、房水、玻璃体中的NGB表达均高于IMH组(F=494.433、143.923、2568.291;P均<0.001)。NGB在血清中、玻璃体中PDR4组表达量均低于PDR5组(t=-9.766、-27.578,P均<0.001),PDR4组表达量均低于PDR6组(t=-29.678、-26.419,P均<0.001),PDR5组表达量均低于PDR6组(t=-15.117,P<0.001;t=-3.231,P=0.003)。在房水中表达量,各组间两两比较均无差异(P均>0.05)。IMH组、PDR4组、PDR5组、PDR6组患者内界膜或视网膜前纤维增殖膜中NGB表达阳性率分别为0、(6.12±2.12)%、(13.43±2.05)%、(16.39±2.46)%。PDR4组低于PDR5组(t=-21.55,P<0.001);PDR4低于PDR6组(t=-25.059,P<0.001);PDR5低于PDR6组(t=-7.238,P<0.001)。结论 NGB在PDR患者血清、房水、玻璃体和视网膜前纤维增殖膜中的表达较对照组明显增加,且血清、玻璃体和视网膜前纤维增殖膜中的NGB表达量随病情加重呈递增趋势。
Objective To investigate the expression of neuroglobin (NGB) in aqueous humor, vitreous, pre-retinal proliferation membrane and serum in patients with proliferative diabetic retinopathy (PDR). Design a clinical case-control study. Subjects of Shanxi Eye Hospital were followed up and diagnosed as PDR patients in 30 cases, of which Ⅳ, Ⅴ, Ⅵ patients in 10 cases, 10 cases of patients with idiopathic macular hole (IMH) as a control. Methods The aqueous humor, vitreous body, pre-retinal fibroplasmic membrane (PDR group) or internal limiting membrane (IMH group) were collected by vitrectomy. Preoperative venous blood pumping serum. ELISA method was used to quantitatively detect the expression of NGB in aqueous humor, vitreous body and serum in PDR patients and IMH patients. Immunohistochemical staining was used to observe the expression of NGB in the proliferative and intramembranous membranes. The overall differences of NGB expression in aqueous humor, vitreous body and serum, and the positive rate of NGB expression in the pre-retinal fibrosis membrane and in the inner limiting membrane in each group were compared using one-way analysis of variance (ANOVA) and LSD-t multiple comparisons between groups. The main indicators of serum, aqueous humor, vitreous, pre-retinal proliferation of membrane (PDR group) and the inner limiting membrane (IMH group) NGB expression. Results The expression of NGB in serum, aqueous humor and vitreous of PDR group was higher than that of IMH group (F = 494.433, 143.923, 2568.291, P <0.001). In serum, the expression of PDR4 in vitreous was lower than that of PDR5 (t = -9.766, -27.578, P <0.001) (All P <0.001). The expression of PDR5 group was lower than that of PDR6 group (t = -15.117, P <0.001; t = -3.231, P = 0.003). In aqueous humor expression, there was no difference between the two groups (P> 0.05). The positive rates of NGB expression in IMD group, PDR4 group, PDR5 group and PDR6 group were (6.12 ± 2.12)%, (13.43 ± 2.05)% and (16.39 ± 2.46)%, respectively . PDR4 group was lower than PDR5 group (t = -21.55, P <0.001); PDR4 was lower than PDR6 group (t = -25.059, P <0.001); PDR5 was lower than PDR6 group (t = -7.238, P <0.001). Conclusion The expression of NGB in serum, aqueous humor, vitreous and pre-retinal proliferation membrane of PDR patients was significantly higher than that of the control group. The expression of NGB in serum, vitreous and pre-retinal proliferation membrane increased with the progression of disease.