目的：探讨血清血管内皮细胞生长因子(VEGF)、内皮抑素(ES)、血小板反应蛋白(TSP)、组织激肽释放酶(TKLK)及可溶性细胞间黏附分子-1(sICAM-1)水平在糖尿病视网膜病变(DR)患者血清中的变化及其临床意义。

方法：选取我院2014-01/2016-12收集的无眼底病变的糖尿病患者60例(DM组)、非增殖性糖尿病视网膜病变患者60例(NPDR组)、增殖性糖尿病视网膜病变患者60例(PDR组)和同期健康体检对象60例(对照组)，检测四组患者血清VEGF、ES、TSP、TKLK、sICAM-1水平并进行比较分析。

结果：PDR组患者的血清VEGF、TKLK、sICAM-1水平均显著高于NPDR组、DM组、对照组(P<0.05)； PDR组患者的血清ES水平均显著低于NPDR组、DM组、对照组(P<0.05)。NPDR组患者的血清VEGF、TKLK、ES水平均显著高于DM组和对照组(P<0.05)。NPDR组患者的血清VEGF与ES、TKLK、sICAM-1水平均呈显著的正相关关系(P<0.05)。PDR组患者的血清VEGF与TKLK、sICAM-1水平均呈显著的正相关关系(P<0.05)，PDR组患者的血清VEGF与ES、TSP相关性不显著(P>0.05)。

结论：DR患者血清ES、TSP、TKLK、sICAM-1水平均发生显著改变，通过调节VEGF水平影响DR进程。

METHODS: Selected 60 patients with non-proliferative diabetic retinopathy(NPDR group), 60 patients with proliferative diabetic retinopathy(PDR group)were enrolled in this study. Sixty diabetic patients without diabetic retinopathy(DM group)and 60 healthy people(control group)were also enrolled. Collection time was from January 2014 to December 2016. Serum levels of VEGF, ES, TSP, TKLK and sICAM-1 were measured and compared.

RESULTS: The levels of serum VEGF, TKLK and sICAM-1 in PDR group were significantly higher than those in NPDR group, DM group and control group(P<0.05). The ES of PDR group was significantly lower than that of NPDR group, DM group and control group(P<0.05). The levels of VEGF, TKLK and ES in the NPDR group were significantly higher than those in the DM group and the control group(P<0.05). The serum VEGF in the NPDR group was positively correlated with the levels of ES, TKLK and sICAM-1(P<0.05). The serum VEGF of PDR group was positively related to the levels of TKLK and sICAM-1(P<0.05). There was no significant relationship between serum VEGF with ES and TSP in PDR group(P>0.05).

CONCLUSION: The levels of serum ES, TSP, TKLK and sICAM-1 in patients with DR have changed significantly, and the process of retinopathy has been affected by regulating the level of VEGF.