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1、糖尿病视网膜病变发病机制中VEGF与PEDF的研究进展【摘要】 糖尿病视网膜病变(diabeicretinopathy,DR)是糖尿病最常见和最严重微血管并发症之一,其基本病理改变是血—视网膜屏障(bloodretinalbarrier,BRB)破坏,新生血管形成。后期新生血管膜收缩牵拉视网膜脱离。DR的发病机制十分复杂,至今尚未完全阐明。任何病理改变在本质上均是体内动态平衡的失调,新生血管的形成亦然,血管刺激因素增强和(或)抑制因素减少使两者平衡失调即所谓的“血管生成开关”。血管内皮生长因子(vascuarendothelialgrowthf
2、actor,VEGF)和色素上皮衍生因子(pigmentepithelium-derivedfactor,PEDF)作为血管生成因子与血管抑制因子的一对典型代表,在糖尿病视网膜病变中的作用已逐渐被人们认识。本文就二者在糖尿病视网膜病变中作用的研究进展做一综述。并为DR的相关药物治疗提供思路。【关键词】糖尿病视网膜病变;VEGF;PEDF PerspectivesonVEGFandPEDFinthepathogenesisofdiabeticretinopathyXiao-JuanFan,Xiao-LingZhangDepartmentofOph
3、thalmology,theFirstAffiliatedHospitalofXi'anJiaotongUniversity,Xi'an710061,ShaanxiProvince,ChinaAbstractDiabeticretinopathyisoneofthemostfrequentlyandthemostseveremicrangiumcomplicationsofdiabetesmellitus,thefundamentalpathologycharacteristicofDRisbreakdownoftheblood-retinalb
4、arrierandneovascularization.InthelaterstageofDR,theformationoftheepiretinalmembrane,whichmaytractatestheretinaandproducedetachmentoftheretina,resultsinprogressivedeteriorationofvision.Thepathogenesisisverycomplexandhasnotbeenelucidatedcompletely.Retinalneovascularizationresul
5、tsfrombothincreasingofvascularstimulatingfactorandreducingofvascularinhibitingfactor.Astheclassicrepresentsofvascularstimulatingandinhibitingfactor,thefunctionofvascularendothelialgrowthfactor(VEGF)andpigmentepithelium-derivedfactor(PEDF)inpathogenesisofDRhasbeenrecognizedgra
6、dually.ThisarticlesummarizedthefunctionofbothVEGFandPEDFandprovidedideasformedicinetherapeutictoDR.·KEYWORDS:diabeticretinopathy;VEGF;PEDF 0引言糖尿病视网膜病变(diabeticretinopathy,DR)是糖尿病最常见和最严重微血管并发症之一,它已成为大多数发达国家工作年龄人群致盲的首要原因。在中国,目前有超过5000万糖尿病患者,并以每年10%的速度增加,因DR而致盲者已达7万多人。located
7、intheTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennightcameDR的患病率随糖尿病病程的延长而增加,5a内DR患病率为44.4%,7a后为56%[1],世界范围内糖尿病患者人数的增加提示糖尿病视网膜病变将来依然是视力丧失和视功能
8、损害的主要原因。近年来,随着细胞生物学和分子生物学技术的深入研究,细胞因子在DR中的作用已被学者们广泛关注和研究。血管内皮生长因子(va