增殖性糖尿病视网膜病变患者视网膜前膜中促红细胞生成素受体表达及临床意义

董蒙;狄浩浩;陈松;王昀

【期刊名称】《中国实用眼科杂志》

【年(卷),期】2015(033)001

【摘要】Objective To investigate the expression of erythropoietin receptor (EpoR) in epiretinal membranes of proliferative diabetic retinopathy (PDR) and to analyze the relationship between levels of EpoR and vision prognosis of PDR.Methods Twenty-four PDR samples and 12 retinal vein occlusion (RVO) samples were collected in Tianjin Eye Hospital.The levels of EpoR expression in epiretinal membranes were detected by immunohistochemistry,and their association with vision prognosis was statistically analyzed.Results The levels of expression of EpoR in epiretinal membranes of PDR group and RVO group were (0.0167±0.0070) and (0.0119±0.0030) respectively,showing significant difference between the two groups (t =2.907,P =0.006).Postoperatively,BCVA improved in 16 eyes (66.7％),remained unchanged in 5 eyes (20.8％) and declined in 3 eyes (12.5％).The integrated optic density (IOD) between improved group and unimproved group was statistically significant (P =0.039),and the level of unimproved group was higher than the improved group.Spearman rank relationship analysis showed that the expression levels of EpoR had positive correlation with visual acuity of the last investigation (r =0.514,P =0.010).Conclusions The expression of EpoR up-regulates in PDR epiretinal membranes,indicating that EpoR plays an important role in the pathogenesis of PDR.The increased level of EpoR in epiretinal membranes maybe affect on the visual prognosis of PDR.%目的 检测促红细胞生成素受体(EpoR)在增殖性糖尿病视网膜病变(PDR)患者和非糖尿病患者视网膜前膜中的表达差异,并探讨EpoR表达水平与PDR术后视力预后的关系.方法 临床对照实验研究.收集2011年6月至2012年8月于天津市眼科医院行玻璃体切割手术并剥除视网膜前膜的PDR患者24只眼,为PDR组,并收集同期行相同手术的视网膜静脉阻塞(RVO)患者12只眼作为对照组.采用免疫组织化学染色法检测术中剥除的两组视网膜前膜上EpoR的表达情况,并结合临床及病理学资料对EpoR在PDR发病机制中的作用进行分析.采用t检验对两组视网膜前膜中EpoR表达量的差异进行比较,Pearson相关系数分析EpoR表达量与PDR患者术后最佳矫正视力之间的相关性.结果 EpoR在PDR组和对照组的表达分别为(0.0167±0.0070)、(0.0119±0.0030),且差异有统计学意义(t =2.907,P=0.006).EpoR表达水平与PDR术后矫正视力有关联(r=0.514,P=0.010),视力提高组EpoR的平均累积光密度值低于视力非提高组.结论 EpoR在PDR视网膜前膜中表达增高,Epo-EpoR途径可能在PDR发病机制中起重要作用,且EpoR在视网膜前膜表达的升高可能影响PDR视力的预后.