方法：回顾性分析本院收治的糖尿病患者71例，根据有无DR及病变程度分为三组：单纯糖尿病组(n=31)、单纯型DR组(n=22)、增殖型DR组(n=18)，比较各组微血管病变发生率。同时，取患者空腹肘静脉血，采用ELISA试剂盒测定血清VEGF水平，采用流式细胞仪检测内皮细胞(ECs)、内皮祖细胞(EPCs)、循环祖细胞(CPCs)计数。

结果：各组糖尿病肾病和糖尿病神经病变发生率有明显差异，增殖型DR组高于单纯型DR组和单纯糖尿病组，差异有统计学意义(P<0.05)。各组VEGF水平有明显差异，增殖型DR组高于单纯型DR组和单纯糖尿病组，单纯型DR组高于单纯糖尿病组； 合并糖尿病肾病及糖尿病神经病变者VEGF水平高于非合并者，差异均有统计学意义(P<0.05)。各组之间ECs、EPCs、CPCs水平有明显差异，增殖型DR组ECs高于单纯型DR组和单纯糖尿病组，单纯型DR组高于单纯糖尿病组； 增殖型DR组EPCs、CPCs水平低于单纯型DR组和单纯糖尿病组，单纯型DR组低于单纯糖尿病组，差异有统计学意义(P<0.01)。增殖型DR患者的VEGF水平与ECs水平呈正相关性(P<0.01)，与EPCs、CPCs水平呈负相关性(P<0.01)。

结论：VEGF在糖尿病视网膜病变，尤其是增殖型糖尿病视网膜病变的临床诊断和医疗中，有重要意义。

METHODS:Seventy-one patients with diabetes were analyzed retrospectively, and divided into 3 groups according to the degree of DR:the pure diabetes group(n=31), the pure DR group(n=22)and the proliferative DR group(n=18). The incidence of microvascular damage was compared; At the same time, fasting venous blood of patients was extracted, and the VEGF levels were detected with ELISA kits, the endothelial cells(ECs), endothelial progenitor cells(EPCs)and circulating progenitor cells(CPCs)counts were detected with flow cytometry.

RESULTS:The incidence of diabetic nephropathy and diabetic neuropathy was significantly different in three groups, proliferative DR group was higher than pure DR group and pure diabetes group, the difference was statistically significant(P<0.05). There was difference in VEGF levels among groups, the proliferative DR group was higher than the pure DR group the pure diabetes group, and the pure DR group was higher than the pure diabetes group(P<0.05,P<0.01). VEGF levels in patients complicated with diabetic nephropathy and diabetic neuropathy were higher than the non-complicated patients, the differences were statistically significant(P<0.05). There was significant difference in ECs, EPCs and CPCs among groups, the ECs of proliferative DR group was higher than that of the pure DR group the pure diabetes group, and that of the pure DR group was higher than that of the pure diabetes group(P<0.01), but EPCs and CPCs reversed. The VEGF level had positively correlation with ECs level(P<0.01), and had negatively correlation with EPCs and CPCs levels(P<0.01)in patients with proliferative DR.

CONCLUSION:VEGF has important significance in the clinical diagnosis and medical treatment of diabetic retinopathy, especially proliferative diabetic retinopathy.