摘要
目的探究视网膜静脉阻塞(RVO)黄斑水肿患者血清内皮素1(ET⁃1)、N末端B型利钠肽原(NT⁃proBNP)、补体1q/肿瘤坏死因子相关蛋白9(CTRP9)的表达,分析血清ET⁃1、NT⁃proBNP、CTRP9与患者病情和预后的关系。方法回顾性病例对照研究。选取2020年6月至2023年6月在本院眼科就诊的RVO黄斑水肿患者106例(106只眼)为病例组,另选取同期就诊的单纯RVO无黄斑水肿患者50例(50只眼)纳入单纯组,同期的眼部健康者50例纳入对比组。病例组患者依次依据黄斑水肿程度和预后情况进行分组,比较血清ET⁃1、NT⁃proBNP、CTRP9水平。利用Spearman法分析血清ET⁃1、NT⁃proBNP、CTRP9与病例组患者黄斑水肿程度的相关性;利用ROC分析血清ET⁃1、NT⁃proBNP、CTRP9对病例组患者预后不良的预测价值。结果病例组、单纯组和对比组的ET⁃1、NT⁃proBNP、CTRP9差异均有统计学意义差异显著,就ET⁃1、NT⁃proBNP而言,病例组>单纯组>对比组,就CTRP9而言,病例组<单纯组<对比组(均P<0.05)。不同程度的病例组患者ET⁃1、NT⁃proBNP、CTRP9水平不同,就ET⁃1、NT⁃proBNP而言,重度组>中度组>轻度组,就CTRP9而言,重度组<中度组<轻度组(均P<0.05)。ET⁃1、NT⁃proBNP与黄斑水肿程度呈正相关(r_(s)=0.436,r_(s)=0.471),CTRP9与黄斑水肿程度呈负相关(r_(s)=-0.502)(均P<0.05)。预后不良的病例组患者ET⁃1、NT⁃proBNP高于预后良好组,CTRP9低于预后良好组(均P<0.05)。血清ET⁃1、NT⁃proBNP、CTRP9预测病例组患者预后不良的AUC和灵敏度低于三者组合预测模型的AUC和灵敏度,Z_(联合-ET-1)=2.823、Z_(联合-NT-proBNP)=2.146、Z_(联合-CTRP9)=2.120(均P<0.05)。结论RVO合并黄斑水肿患者血清ET⁃1、NT⁃proBNP水平较高,CTRP9水平较低,ET⁃1、NT⁃proBNP、CTRP9的水平与患者的黄斑水肿程度和预后有关,联合检测血清水平可很好的预测患者的预后情况。
Objective To investigate the expression of serum endothelin-1(ET-1),N-terminal pro-B-type natriuretic peptide(NT-proBNP),complement 1q/tumor necrosis factor related protein 9(CTRP9)in patients with retinal vein occlusion(RVO)combined with macular edema,and to analyze the relationship between serum ET-1,NT-proBNP,CTRP9 with disease condition and prognosis.Methods A retrospective case-control study.A total of 106 patients(106 eyes)with macular edema caused by RVO who visited the ophthalmology department of our hospital from June 2020 to June 2023 were selected as the case group.In addition,50 patients with simple RVO who visited the same period were regarded as the simple group,and 50 healthy eye patients who visited the same period were as the control group.Patients in the case group were grouped based on the degree of macular edema and prognosis,and serum levels of ET-1,NT-proBNP,and CTRP9 were compared.Spear’man method was applied to analyze the correlation between serum ET-1,NT-proBNP,CTRP9 and the degree of macular edema in the case group.ROC was applied to analyze the predictive value of serum ET-1,NT-proBNP,and CTRP9 for poor prognosis in the case group.Results There were obvious differences in ET-1,NTproBNP,and CTRP9 among the case group,simple group,and control group.In terms of ET-1 and NT-proBNP,the case group>simple group>control group,and in terms of CTRP9,the case group<simple group<control group(all P<0.05).The levels of ET-1,NT-proBNP,and CTRP9 varied among patients of different degrees in the case group.In terms of ET-1 and NT-proBNP,the severe group>the moderate group>the mild group,while in terms of CTRP9,the severe group<the moderate group<the mild group(all P<0.05).ET-1 and NT-proBNP were positively correlated with the degree of macular edema(r=0.436,r=0.471),while CTRP9 was negatively correlated with the degree of macular edema(r=-0.502)(all P<0.05).The ET-1 and NT-proBNP levels in the poor prognosis group were higher than those in the good prognosis group,while CTRP9 level was lower than that in the good prognosis group(all P<0.05).The AUC and sensitivity of serum ET-1,NT-proBNP,and CTRP9 in predicting poor prognosis of patients in the case group were lower than those of the three combined prediction model,with Z_(combination-ET-1)=2.823,Z_(combination-NT-proBNP)=2.146,and Z_(combination-CTRP9)=2.120(all P<0.05).Conclusions Patients with RVO combined with macular edema have higher levels of serum ET-1 and NTproBNP,while lower level of CTRP9.The levels of ET-1,NT-proBNP,and CTRP9 are related to the degree of macular edema and prognosis.Combined detection of serum levels can effectively predict the prognosis.
作者
李成茂
李维娜
Li Chengmao;Li Weina(Department of Ophthalmology,910 Hospital of the Joint Logistics Support Force of the People's Liberation Army of China,Quanzhou 362000,China)
出处
《临床眼科杂志》
2025年第2期121-126,共6页
Journal of Clinical Ophthalmology
基金
泉州市2021年医疗卫生领域指导性科技计划项目[泉科(2021)150号⁃166]。
关键词
视网膜静脉阻塞
黄斑水肿
内皮素1
N末端B型利钠肽原
补体1q/肿瘤坏死因子相关蛋白9
病情
预后
Retinal vein occlusion
macular edema
Endothelin 1
N-terminal pro-B-type natriuretic peptide
Complement 1q/tumor necrosis factor related protein 9
Disease condition
Prognosis
作者简介
通信作者:李维娜,Email:liweina2096@126.com。
