[1]杨洁,朱晓敏,胡子毅,等.糖尿病视网膜病变患者血清转化生长因子-β水平变化及其在监测抗VEGF药物治疗效果中的作用[J].眼科新进展,2021,41(12):1158-1163.[doi:10.13389/j.cnki.rao.2021.0242]
　YANG Jie,ZHU Xiaomin,HU Ziyi,et al.Changes in serum transforming growth factor beta level in patients with diabetic retinopathy and its role in monitoring the therapeutic effect of anti-vascular endothelial growth factor drugs[J].Recent Advances in Ophthalmology,2021,41(12):1158-1163.[doi:10.13389/j.cnki.rao.2021.0242]
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糖尿病视网膜病变患者血清转化生长因子-β水平变化及其在监测抗VEGF药物治疗效果中的作用/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
41卷
期数:
2021年12期
页码:
1158-1163
栏目:
应用研究
出版日期:
2021-12-05

文章信息/Info

Title:
Changes in serum transforming growth factor beta level in patients with diabetic retinopathy and its role in monitoring the therapeutic effect of anti-vascular endothelial growth factor drugs
作者:
杨洁; 朱晓敏; 胡子毅; 张会民; 冯子龙
437100　湖北省咸宁市，湖北科技学院附属第一医院眼科（杨洁，朱晓敏）；116000　辽宁省大连市，大连市第三人民医院眼科（胡子毅，张会民，冯子龙）
Author(s):
YANG Jie1; ZHU Xiaomin1; HU Ziyi2; ZHANG Huimin2; FENG Zilong2
1.Department of Ophthalmology，the First Affiliated Hospital of Hubei University of Science and Technology，Xianning 437100，Hubei Province，China
2.Department of Ophthalmology，the Third People’s Hospital of Dalian,Dalian 116000，Liaoning Province， China
关键词:
糖尿病视网膜病变; 转化生长因子-β; 抗血管内皮生长因子; 黄斑中心凹厚度
Keywords:
diabetic retinopathy;  transforming growth factor beta;  anti-vascular endothelial growth factor drugs;  foveal macular thickness
分类号:
R774.1
DOI:
10.13389/j.cnki.rao.2021.0242
文献标志码:
A
摘要:
目的　探究糖尿病视网膜病变（DR）患者血清转化生长因子-β（TGF-β）水平变化及其在监测抗血管内皮生长因子（VEGF）药物治疗效果中的作用。方法　本研究纳入2020 年1至2020年12 月本院收治的增生型DR（PDR）患者40例（PDR组）、非PDR（NPDR）患者40例（NPDR组）、无DR症状的糖尿病患者40例（糖尿病组）以及40位年龄、性别匹配的健康对照者（对照组）。检测所有受试者血清VEGF-A和TGF-β水平。所有DR患者均接受玻璃体内注射雷珠单抗，1个月后检测受试者黄斑中心凹厚度（FMT）和血清TGF-β水平，采用受试者工作特征（ROC）曲线分析血清TGF-β诊断各组患者的曲线下面积（AUC），采用Spearman秩相关分析血清VEGF-A、TGF-β水平与FMT、糖化血红蛋白（HbAlc）和糖尿病病程等指标之间的相关性。结果　治疗前糖尿病组、NPDR组、PDR组患者血清VEGF-A、TGF-β水平均高于对照组（均为P<0.05）。NPDR组和PDR组患者血清TGF-β水平和FMT较对照组和糖尿病组均升高（均为P<0.05），且PDR组升高更明显，与对照组、糖尿病组、NPDR组患者相比，差异均有统计学意义（均为P<0.05）。ROC曲线分析结果显示，血清TGF-β水平可以诊断糖尿病患者（AUC=0.860，P<0.001）、糖尿病人群中的DR患者（AUC=0.756，P<0.001）以及鉴别诊断NPDR和PDR患者（AUC=0.734，P<0.001）。DR患者血清TGF-β水平与HbAlc、糖尿病病程均呈正相关性（r=0.703、0.656，均为P<0.001）。治疗后1个月NPDR组患者血清TGF-β水平和FMT值均显著低于治疗前基线值（均为P<0.001），而PDR组患者治疗前后血清TGF-β水平和FMT值差异均无统计学意义（均为P>0.05）。治疗后1个月，DR患者血清TGF-β水平与FMT值呈正相关性（r=0.808，P<0.001）；而血清VEGF-A水平与FMT值则无相关性（r=0.013，P=0.907）。结论　血清TGF-β水平可以被认为是预测从NPDR到PDR疾病进展的一个生物标志物，它也可能是抗VEGF药物临床疗效的次要终点。
Abstract:
Objective　To explore the changes in serum transforming growth factor beta (TGF-β) level in patients with diabetic retinopathy (DR) and its role in monitoring the therapeutic effects of anti-vascular endothelial growth factor (VEGF) drugs.Methods　This study included 40 patients with proliferative diabetic retinopathy (PDR) in the PDR group, 40 patients with non-PDR in the NPDR group, and 40 patients with non-DR in the diabetes mellitus (DM) group, all patients being treated in our hospital from January to December 2020. In addition, 40 age- and sex-matched healthy individuals were selected in the control group.Serum VEGF-A and TGF-β levels were measured. All DR patients received intravitreal injection of ranibizumab. The foveal macular thickness (FMT) and serum TGF-β level were measured one month later. The receiver operating characteristic (ROC) curve was used to analyze the area under curve (AUC) for serum TGF-β, and Spearman rank correlation was used to analyze the correlation between serum VEGF-A, TGF-β, FMT, glycated hemoglobin (HbAlc), and the course of diabetes.Results　The levels of VEGF-A and TGF-β in the DM group, NPDR group, and PDR group were higher than those in the control group (all P<0.05). Serum TGF-β level and FMT in the NPDR group and PDR group were higher than those in the control group and DM group (all P<0.05), especially in the PDR group, it increased more significantly, and the difference was statistically significant compared with the control group, DM group, NPDR group (all P<0.05). The ROC curve showed that serum TGF-β level could be used for diagnosis of diabetic patients (AUC=0.860,P<0.001), DR patients (AUC=0.756,P<0.001) and differential diagnosis of NPDR and PDR patients (AUC=0.734,P<0.001). The serum TGF-β level in DR patients was positively correlated with HbAlc and the course of diabetes (r=0.703, 0.656, both P<0.001). The postoperative serum TGF-β level and FMT in the NPDR group were significantly lower than the preoperative baselines (all P<0.001), but in the PDR group, there were no significant differences in the serum TGF-β level and FMT before and after treatment (all P>0.05). At one month after treatment, the serum TGF-β level was positively correlated with FMT in the DR patients (r=0.808, P<0.001), while there was no correlation between serum VEGF-A level and FMT (r=0.013, P=0.907).Conclusion　Serum TGF-β level can be considered as a biomarker to predict the progression of DR from NPDR to PDR, and it may also be a secondary endpoint of clinical efficacy of anti-VEGF drugs.

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更新日期/Last Update: 2021-12-05