目的：探讨RBP4在增生期糖尿病性视网膜病变(proliferative diabetic retinopathy， PDR)炎症反应中的作用。

方法：收集2017-02/07在武汉大学人民医院眼科中心就诊患者65例66眼玻璃体标本， 其中PDR组23例，非增生期糖尿病性视网膜病变(nonproliferative diabetic retinopathy， NPDR)组16例，非糖尿病患者26 例作为对照组。各组患者人口基线特征相匹配，PDR组及NPDR组患者糖尿病病程、血糖水平及糖化血红蛋白水平差异均有统计学意义(P<0.05)。ELISA检测各组玻璃体标本中视黄醇结合蛋白4(RBP4)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的浓度。应用单因素方差分析比较并分析各组玻璃体中RBP4、IL-6、TNF-α的浓度。采用Pearson相关分析法分析RBP4与IL-6的相关性。

结果：RBP4在PDR组、NPDR组、对照组中浓度分别为13.68±2.66、11.03±1.12、10.45±1.17μg/mL。IL-6在PDR组、NPDR组、对照组中浓度分别为56.0±10.27、20.92±5.77、10.26±1.91pg/mL。PDR组中RBP4、IL-6浓度明显高于对照组及NPDR组，3组间总体差异有统计学意义(F=12.135、161.167，P<0.01)，NPDR组玻璃体中RBP4浓度与对照组RBP4浓度差异无统计学意义(P>0.05)。NPDR组玻璃体中IL-6浓度较对照组显著升高，差异具有统计学意义(P<0.05)。玻璃体中RBP4浓度与IL-6浓度成明显正相关(r=0.606，P=0.001)。

结论：RBP4可能参与糖尿病性视网膜病变增生期的炎症反应过程，为疾病的诊断与治疗提供新的思路。

METHODS: A total of 65 patients(66 eyes)were enrolled in Department of Ophthalmology, Renmin Hospital of Wuhan University from February 2017 to July 2017 with the informed consent. The patients were divided into PDR group(23 cases)and NPDR group(16 cases). Twenty-six patients without diabetic mellitus(DM)served as control group. The demography was matched among the groups, but the course of DM, the blood glucose level and the HbA1c level were elevated in the PDR group and the NPDR group(all P<0.05). Vitreous samples were collected during the procedure of vitrectomy. RBP4, IL-6, TNF-α concentrations in vitreous specimens were detected by ELISA. The differences of vitreous RBP4, IL-6 and TNF-α in various groups were statistically analyzed by ANOVA, respectively. The correlations between RBP4 and IL-6, TNF-α were calculated by Pearson correlation analysis.

RESULTS: The concentration of RBP4 in PDR group, the NPDR group and control group were 13.68±2.66, 11.03±1.12, 10.45±1.17μg/mL, and the concentration of IL-6 were 56.0±10.27, 20.92±5.77, 10.26±1.91pg/mL. RBP4 and IL-6 concentrations were elevated in PDR group compared with NPDR group and control group, with significant difference among three groups(F=12.135, 161.167; P<0.01). IL-6 concentrations in vitreous increased in the NPDR group in comparison with control group(P<0.05). RBP4 concentrations had no significant difference between the NPDR group and the group(P>0.05). Pearson correlation coefficient was significant positive between RBP4 concentration and IL-6 concentration(r=0.606, P=0.001).

CONCLUSION: RBP4 is probability involved in the inflammation pathogenesis of PDR. These results indicate that RBP4 could be a new target for the diagnosis and treatment of PDR.