目的：研究增殖性糖尿病视网膜病变(PDR)玻璃体腔注射抗-VEGF药物bevacizumab后对增殖膜中结缔组织生长因子(CTGF)及色素上皮衍生因子(PEDF)的影响。

方法：回顾2015-01/2016-12入本院行增殖性糖尿病视网膜病变治疗的患者117例126眼，采用病例对照的研究方法，将所选病例随机分为两组，分别为A组60例63眼和B组57例63眼。其中A组单纯进行玻璃体切割手术，B组患者在玻璃体切割术前玻璃体腔注射0.05mL/1.25mg bevacizumab。在手术中剥离取用两组患者的视网膜增殖膜进行染色，然后进行组织病理学观察，观察两组患者视网膜增殖膜中原始细胞和新生血管的变化，以及患者增殖膜中CTGF和PEDF因子的表达。

结果：在对两组患者CTGF、PEDF因子表达进行观察发现，两组患者视网膜增殖膜中的CTGF和PEDF都在细胞质内表达。其中A组呈现出38眼阳性表达，阳性表达率为60.3%，相比于A组而言，B组的CTGF的阳性表达率92.1%明显更高，两组差异有统计学意义(P<0.05)。而两组的PEDF阳性表达率分别为90.5%和95.2%，差异无统计学意义(P>0.05)。

结论：PDR患者在玻璃体腔注射抗VEGF药物bevacizumab后，视网膜的新生血管明显减少，有利于玻璃体切割手术的进行。且PDR患者玻璃体腔注射bevacizumab后，CTGF的阳性表达率明显增高，而PEDF因子在前膜上的表达则没有明显的变化。

AIM: To investigate the effect of intravitreal injection of anti-vascular endothelial growth factor(VEGF)drug Bevacizumab on connective tissue growth factor(CTGF)and pigment epithelium derived factor(PEDF)in proliferative membranes in patients with proliferative diabetic retinopathy(PDR).

METHODS: From January 2015 to December 2016, 117 patients(126 eyes)with PDR were analyzed using the case-control study. The selected cases were randomly divided into two groups, respectively, Group A of 60 cases(63 eyes)and Group B of 57 cases(63 eyes). The Group A was treated with vitrectomy alone, while the Group B received intravitreal injection of 0.05mL/1.25mg bevacizumab before vitrectomy. The peeled epiretinal membranes in patients were stained and then the histopathological changes were observed for primitive cells and angiogenesis, the expression of CTGF and PEDF were tested.

RESULTS: The expression of CTGF and PEDF in the proliferative membrane of the two groups were expressed in the cytoplasm. The Group A showed positive expression in 38 cases, the positive rate was 60.3%. Compared with Group A, the positive expression rate of CTGF in Group B(92.1%)was significantly higher(P<0.05). The positive expression rates of PEDF in the two groups were 90.5% and 95.2% respectively, and there was no significant difference between the two groups(P>0.05).

CONCLUSION: In patients with PDR after intravitreal injection of bevacizumab, the retinal neovascularization is significantly reduced, which is conducive to vitrectomy. The positive expression rate of CTGF significantly increased in patients with PDR after intravitreal injection of bevacizumab, but there was no significant change in the expression of PEDF in the anterior membrane.

2014年霍英东教育基金会第十四届高等院校青年教师基金基础性研究课题(No.141038)