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[摘要]
目的:探讨妊娠期高血压视网膜病变患者产前血管新生因子及血管内皮功能变化,分析其与视网膜病变程度的关系。
方法:以82例妊娠期高血压视网膜病变患者作为研究对象,设为观察组,依据Duker-Elder眼底分期标准可分为Ⅰ期(n=42)、Ⅱ期(n=25)和Ⅲ期(n=15),另选取妊娠高血压无视网膜病变者作为对照组,比较各组患者血管新生因子及血管内皮功能指标水平,并分析各指标与视网膜病变程度的关系。
结果:观察组患者VEGF、IGF-1和ET-1水平显著高于对照组,差异均有统计学意义(P<0.01),且随着眼底病变程度的加重,VEGF、IGF-1和ET-1水平均显著升高; 观察组患者NO水平显著低于对照组,差异有统计学意义(P<0.01),且随着眼底病变程度的加重,NO水平显著降低。Spearman相关分析结果表明,妊娠高血压视网膜病变程度与VEGF、IGF-1和ET-1水平呈显著正相关性,与NO呈负相关性。
结论:妊娠期高血压视网膜病变患者存在明显血管新生因子水平异常,血管内皮功能紊乱,与视网膜病变程度呈一定相关性。
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[Abstract]
AIM: To investigate the changes of angiogenic factors and vascular endothelial function in patients with hypertensive retinopathy complicating pregnancy, and to analyze the relationship between the relevant factors and the degree of retinopathy.
METHODS: Totally 82 cases of patients with hypertensive retinopathy in pregnancy were selected as the research subjects. According to the Duker-Elder fundus staging criteria, they were divided into stage Ⅰ group(n=42), patients with stage Ⅱ group(n=25)and stage Ⅲ group(n=15), in addition, pregnancy hypertension patients without retinopathy were selected as control group. We compared the levels of angiogenic factors and vascular endothelial function among groups, and analyzed the relationship between the levels of relevant factors and retinopathy.
RESULTS:The levels of vascular endothelial growth factor(VEGF), insulin like growth factors(IGF-1)and endothelin(ET)-1 in the observation group were significantly higher than those in the control group(P<0.01), and the levels were significantly increased with the increase of fundus staging, the difference was statistically significant. The level of NO in the observation group was significantly lower than that of the control group, with the increase of the fundus staging, the level of NO decreased significantly, and the difference was statistically significant(P<0.01). Spearman correlation analysis showed that the degree of pregnancy induced hypertension retinopathy was positively correlated with VEGF, IGF-1 and ET-1, and negatively correlated with NO(P<0.05).
CONCLUSION: There are obvious angiogenic factors disorder and vascular endotheial dysfunction in patients with hypertensive retinopathy of pregnancy, and its level is correlated with the degree of retinopathy.
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