鼠神经生长因子对青光眼术后患者BDNF、IGF-1、MCP-1、HCY、ET-1、NO水平的影响
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摘要
目的:探讨鼠神经生长因子(mNGF)对青光眼术后视神经的保护作用及对脑源性神经营养因子(BDNF)、胰岛素样生长因子-1(IGF-1)、单核细胞趋化蛋白-1(MCP-1)、同型半胱氨酸(HCY)、血清内皮素-1(ET-1)及一氧化氮(NO)水平的影响。方法:选取90例128眼行小梁切除术的原发性青光眼患者,随机分为对照组(45例62眼)和NGF组(45例66眼)。对照组术后服用三磷酸腺苷二钠片治疗,NGF组在对照组基础上加用注射用鼠神经生长因子治疗。疗程均为1个月。观察比较两组临床疗效、平均光敏度、平均缺损、视网膜神经纤维层(RNFL)厚度、平均杯/盘比及BDNF、IGF-1、MCP-1、HCY、ET-1、NO水平。记录药品不良反应。结果:NGF组治疗后总有效率为84.8%,显著高于对照组的62.9%(P<0.05)。用药2个月后,NGF组平均光敏度较用药前明显升高(P<0.05);用药6个月后,对照组平均杯/盘比较用药前明显升高、RNFL厚度明显下降(P<0.05),NGF组平均光敏度、平均杯/盘比较用药前明显升高、而平均缺损和RNFL厚度明显下降(P<0.05),且以上指标均优于对照组(P<0.05)。与用药前比较,两组患者用药2个月后的BDNF、IGF-1、NO水平明显增高,MCP-1、HCY、ET-1水平明显降低(P<0.05),且NGF组以上指标均优于对照组(P<0.05)。结论:mNGF能有效改善青光眼患者术后视力、视野、RNFL厚度、杯/盘比等指标,对于BDNF、IGF-1、MCP-1、HCY、ET-1、NO水平具有重要的调节作用。
Objective: To investigate the influences of mouse nerve growth factor (mNGF) on the levels of brain-derived neurotrophic factor (BDNF),insulin-like growth factor-1 (IGF-1),monocyte chemotactic protein-1 (MCP-1),homocysteine (HCY),endothelin-1 (ET-1) and NO in patients with glaucoma surgery. Methods: Totally 90 cases of primary glaucoma patients with trabeculectomy were randomly divided into the control group (45 cases with 62 eyes) and NGF group (45 cases with 66 eyes). The control group was treated with adenosine triphosphate disodium after trabeculectomy,NGF group was treated with mNGF on the basis of the control group. The clinical efficacy,mean photosensitivity,mean defect,thickness of retinal nerve fiber layer (RNFL),mean cup/plate ratio and the levels of BDNF,IGF-1,MCP-1,HCY,ET-1 and NO were observed and compared between the groups. The adverse drug reactions were recorded as well. Results: The total effective rate (84.8%) of NGF group after the treatment was significantly higher than that of the control group (62.9%,P<0.05). The mean photosensitivity of NGF group after the 2-month treatment was significantly higher than that before the treatment (P<0.05). After the 6-month treatment,the mean cup/plate ratio of the control group was increased when compared with that before the medication and thickness of RNFL was decreased (P<0.05). The mean photosensitivity and cup/plate ratio of NGF group were increased,the mean defect and thickness of RNFL were decreased (P<0.05),and the improvement of the above indicators of NGF group was better than that of the control group (P<0.05). After the 2-month treatment,the levels of BDNF,IGF-1 and NO were increased,while the levels of MCP-1,HCY and ET-1 were decreased (P< 0.05) in both groups,and the changes of the above indicators in NGF group were greater than those in the control group (P<0.05). Conclusion: mNGF can effectively improve postoperative visual acuity,visual field,RNFL thickness,cup/plate ratio and the other indicators in patients with glaucoma surgery,and has important regulatory effects on the levels of BDNF,IGF-1,MCP-1,HCY,ET-1 and NO.
Objective: To investigate the influences of mouse nerve growth factor (mNGF) on the levels of brain-derived neurotrophic factor (BDNF),insulin-like growth factor-1 (IGF-1),monocyte chemotactic protein-1 (MCP-1),homocysteine (HCY),endothelin-1 (ET-1) and NO in patients with glaucoma surgery. Methods: Totally 90 cases of primary glaucoma patients with trabeculectomy were randomly divided into the control group (45 cases with 62 eyes) and NGF group (45 cases with 66 eyes). The control group was treated with adenosine triphosphate disodium after trabeculectomy,NGF group was treated with mNGF on the basis of the control group. The clinical efficacy,mean photosensitivity,mean defect,thickness of retinal nerve fiber layer (RNFL),mean cup/plate ratio and the levels of BDNF,IGF-1,MCP-1,HCY,ET-1 and NO were observed and compared between the groups. The adverse drug reactions were recorded as well. Results: The total effective rate (84.8%) of NGF group after the treatment was significantly higher than that of the control group (62.9%,P<0.05). The mean photosensitivity of NGF group after the 2-month treatment was significantly higher than that before the treatment (P<0.05). After the 6-month treatment,the mean cup/plate ratio of the control group was increased when compared with that before the medication and thickness of RNFL was decreased (P<0.05). The mean photosensitivity and cup/plate ratio of NGF group were increased,the mean defect and thickness of RNFL were decreased (P<0.05),and the improvement of the above indicators of NGF group was better than that of the control group (P<0.05). After the 2-month treatment,the levels of BDNF,IGF-1 and NO were increased,while the levels of MCP-1,HCY and ET-1 were decreased (P< 0.05) in both groups,and the changes of the above indicators in NGF group were greater than those in the control group (P<0.05). Conclusion: mNGF can effectively improve postoperative visual acuity,visual field,RNFL thickness,cup/plate ratio and the other indicators in patients with glaucoma surgery,and has important regulatory effects on the levels of BDNF,IGF-1,MCP-1,HCY,ET-1 and NO.
引文
1赵堪兴.眼科学[M].第7版.北京:人民卫生出版社,2008:164-166
2杨君红,俞颂平,吴道雷.灯盏花素对青光眼滤过术后中晚期原发性开角型患者视功能的影响[J].中国药师,2015,18(12):2082-2084
3刘艳艳,余涵.原发性急性闭角型青光眼患者持续高眼压状态下行复合式小梁切除术疗效分析[J].新乡医学院学报,2015,32(2):160-162
4中华医学会眼科学分会青光眼学组.我国青光眼引流阀植入手术操作规范专家共识(2016年)[J].中华眼科杂志2016,52(6):407-409
5赵嫏嬛,周陈建.周边虹膜切除术后应用普拉洛芬滴眼液的临床观察[J].药物流行病学杂志,2016,25(2):87-88
6苗森,乔春艳.先天性青光眼的手术治疗进展[J].中华眼科杂志,2014,50(8):626-629
7 Spinnler K,Frohlich T,Arnold GJ,et al.Human tryptase cleaves pro-nerve growth factor(pro-NGF):hints of local,mast cell-dependent regulation of NGF/pro-NGF action[J].J Biol Chem,2011,286(36):31707-31713
8 Tirassa P.The nerve growth factor administrated as eye drops activates mature and precursor cells in subventricular zone of adult rats[J].Arch Ital Biol,2011,149(2):205-213
9沈惠芳,谢欣,杨文忠.注射用鼠神经生长因子多药联合治疗对缺血性视神经病变的作用[J].中国医院药学杂志,2015,35(15):1412-1414
10罗丽华,王艳玲.神经生长因子联合传统用药对前部缺血性视神经病变的疗效[J].国际眼科杂志,2013,13(9):1842-1844
11冯会芳.鼠神经生长因子治疗缺血性视神经病变的疗效分析[J].中国实用神经疾病杂志,2014,17(24):107-108
12孙路建.鼠神经生长因子联合长春西汀治疗急性闭角型青光眼视神经损伤[J].现代中西医结合杂志,2010,19(30):3283-3284
13蒋艳华.神经生长因子对青光眼的保护作用与机制探讨[J].医学综述,2015,21(21):4020-4022
14孙小单,李羽佳.神经生长因子促神经再生作用的研究进展[J].辽宁医学院学报,2010,31(4):377-380
15徐鸿美,卜曙,徐国旭,等.胰导素样生长因子-1(IGF-1)对大鼠视神经损伤的保护作用研究[J].眼科新进展,2013,33(11):1026-1028,1032
16王红霞,李永华,高秀华.单核细胞趋化蛋白-1在原发性急性闭角型青光眼患者房水中的表达及其与小梁切除术预后的关系[J].眼科新进展,2018,38(3):242-246
17陈丽妃,徐帆,黄慧,等.原发性闭角型青光眼血浆同型半胱氨酸水平及其代谢相关指标的检测分析[J].国际眼科杂志,2016,16(6):1092-1095
18 Emre M,Orgul S,Hanfschild T,et al.Increased plasma endothelin-1levels in patients with progressive open angle glaueoma[J].Br J Opthalmol,2005,89(1):60-63
19陈莲,石晶明.青光眼患者视网膜神经节细胞凋亡机制的研究进展[J].眼科新进展,2013,33(4):384-388
2杨君红,俞颂平,吴道雷.灯盏花素对青光眼滤过术后中晚期原发性开角型患者视功能的影响[J].中国药师,2015,18(12):2082-2084
3刘艳艳,余涵.原发性急性闭角型青光眼患者持续高眼压状态下行复合式小梁切除术疗效分析[J].新乡医学院学报,2015,32(2):160-162
4中华医学会眼科学分会青光眼学组.我国青光眼引流阀植入手术操作规范专家共识(2016年)[J].中华眼科杂志2016,52(6):407-409
5赵嫏嬛,周陈建.周边虹膜切除术后应用普拉洛芬滴眼液的临床观察[J].药物流行病学杂志,2016,25(2):87-88
6苗森,乔春艳.先天性青光眼的手术治疗进展[J].中华眼科杂志,2014,50(8):626-629
7 Spinnler K,Frohlich T,Arnold GJ,et al.Human tryptase cleaves pro-nerve growth factor(pro-NGF):hints of local,mast cell-dependent regulation of NGF/pro-NGF action[J].J Biol Chem,2011,286(36):31707-31713
8 Tirassa P.The nerve growth factor administrated as eye drops activates mature and precursor cells in subventricular zone of adult rats[J].Arch Ital Biol,2011,149(2):205-213
9沈惠芳,谢欣,杨文忠.注射用鼠神经生长因子多药联合治疗对缺血性视神经病变的作用[J].中国医院药学杂志,2015,35(15):1412-1414
10罗丽华,王艳玲.神经生长因子联合传统用药对前部缺血性视神经病变的疗效[J].国际眼科杂志,2013,13(9):1842-1844
11冯会芳.鼠神经生长因子治疗缺血性视神经病变的疗效分析[J].中国实用神经疾病杂志,2014,17(24):107-108
12孙路建.鼠神经生长因子联合长春西汀治疗急性闭角型青光眼视神经损伤[J].现代中西医结合杂志,2010,19(30):3283-3284
13蒋艳华.神经生长因子对青光眼的保护作用与机制探讨[J].医学综述,2015,21(21):4020-4022
14孙小单,李羽佳.神经生长因子促神经再生作用的研究进展[J].辽宁医学院学报,2010,31(4):377-380
15徐鸿美,卜曙,徐国旭,等.胰导素样生长因子-1(IGF-1)对大鼠视神经损伤的保护作用研究[J].眼科新进展,2013,33(11):1026-1028,1032
16王红霞,李永华,高秀华.单核细胞趋化蛋白-1在原发性急性闭角型青光眼患者房水中的表达及其与小梁切除术预后的关系[J].眼科新进展,2018,38(3):242-246
17陈丽妃,徐帆,黄慧,等.原发性闭角型青光眼血浆同型半胱氨酸水平及其代谢相关指标的检测分析[J].国际眼科杂志,2016,16(6):1092-1095
18 Emre M,Orgul S,Hanfschild T,et al.Increased plasma endothelin-1levels in patients with progressive open angle glaueoma[J].Br J Opthalmol,2005,89(1):60-63
19陈莲,石晶明.青光眼患者视网膜神经节细胞凋亡机制的研究进展[J].眼科新进展,2013,33(4):384-388