糖尿病视网膜病变发病机制中VEGF及PEDF探究进展.docVIP

糖尿病视网膜病变发病机制中VEGF及PEDF探究进展 　【摘要】 　　糖尿病视网膜病变（diabeic retinopathy, 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(blood retinal barrier, 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（vascuar endothelial growth factor, VEGF）和色素上皮衍生因子（pigment epithelium - derived factor, 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 　　Perspectives on VEGF and PEDF in the pathogenesis of diabetic retinopathy Abstract Diabetic retinopathy is one of the most frequently and the most severe micrangium complications of diabetes mellitus, the fundamental pathology characteristic of DR is breakdown of the blood-retinal barrier and neovascularization . In the later stage of DR, the formation of the epiretinal membrane, which may tractates the retina and produce detachment of the retina, results in progressive deterioration of vision. The pathogenesis is very complex and has not been elucidated completely. Retinal neovascularization results from both increasing of vascular stimulating factor and reducing of vascular inhibiting factor. As the classic represents of vascular stimulating and inhibiting factor, the function of vascular endothelial growth factor(VEGF) and pigment epithelium-derived factor(PEDF) in pathogenesis of DR has been recognized gradually. This article summarized the function of both VEGF and PEDF and provided ideas for medicine therapeutic to DR. · KEYWORDS:diabetic retinopathy; VEGF; PEDF 　　 　　0引言 糖尿病视网膜病变（diabetic retinopathy, 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5 000万糖尿病患者，并以每年10%的速度增加，因DR而致盲者已达7万多人。 DR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（vascular endothelial growth factor ,VEGF）及色素上皮衍生因子（pigment epithelium—derived factor, PEDF）作为与DR联系最为紧密的细胞因子之一，逐渐为人们所重视，现将此方面研究成果综述如下。 1 VEGF的生物学特性及其与糖尿病视网膜