手術を要した未熟児網膜症のインスリン様成長因子1と血管内皮増殖因子の血清濃度推移を測定した1例

Serum levels of insulin-like growth factor-1 and vascular endothelial growth factor in an infant with retinopathy of prematurity needing vitreous surgery

要約　目的：重症未熟児でインスリン様成長因子-1（IGF-1）と血管内皮増殖因子（VEGF）を測定した報告。症例：女児の眼科的管理を日齢24から始めた。在胎27週1日で生まれ，出生時体重は409gであった。日齢87に両眼の未熟児網膜症がzone Ⅱ，stage 3になり，光凝固を行った。日齢108に両眼にベバシズマブを硝子体内投与した。日齢214に右眼輪状締結術，左眼硝子体手術，両眼光凝固追加を行い，最終的に良好な経過になった。結果：生直後から日齢108までIGF-1は20ng/ml以下であった。生直後から日齢77までVEGFは215～440pg/mlであり，日齢84に1,320pg/mlになった。結論：重症未熟児でのIGF-1とVEGF濃度は，修正週数約40週までは低値であり，以後VEGF濃度が上昇した。

Abstract.　Purpose：To report serum levels of insulin-like growth factor-1（IGF-1）and vascular endothelial growth factor（VEGF）in an infant with severe retinopathy of prematurity（ROP）. Case：A female infant was born at the gestational age of 27 weeks weighing 409 g. Ophthalmological control was started on day 24 after birth. The ROP developed to zone Ⅱ stage 3 on day 87 needing photocoagulation. Both eyes received intravitreal bevacizumab on day 108. Right eye received encircling,left eye received vitrectomy,both eyes received photocoagulation on day 214 with eventually favorable outcome. Findings：Serum level of IGF-1 was below 20 ng/ml from birth until day 108. Level of VEGF was between 215 and 440 pg/ml until day 77 and increased to 1,320 pg/ml on day 84. Conclusion：Serum level of IGF-1 and VEGF in this prematurely born infant remained very low until the adjusted gestational age of 40 weeks. Level of VEGF started to increase thereafter.