摘要
目的 探讨不同分期糖尿病性视网膜病变(DR)患者中趋化因子的表达情况及临床意义.方法 选取2019年4月～2021年12月我院收治的DR患者120例,按照DR病情程度将其分为DR Ⅰ期组(11例)、DR Ⅱ期组(21例)、DR Ⅲ期组(28例)、DR Ⅳ期组(35例)及DR Ⅴ组(25例).DR Ⅰ～Ⅲ期为非增生型DR,DR Ⅳ～Ⅴ期为增生型DR.收集各组患者基线资料、相关实验室检查指标及趋化因子[趋化因子样受体1(CMKLR-1)、趋化素(Chemerin)]水平并分组进行比较.采用logistic回归分析评估DR患者病情的影响因素;采用受试者工作特征(ROC)曲线分析趋化因子CMKLR-1、Chemerin对DR患者病情的评估价值.结果 DR Ⅳ期组及Ⅴ期组患者收缩压均高于DR Ⅰ期组、Ⅱ期组及Ⅲ期组;DR Ⅳ期组及Ⅴ期组患者肿瘤坏死因子(TNF)-α、IL-1β、IL-6、核转录因子(NF)-KB、CMKLR-1、Chemerin水平均高于DR Ⅰ期组、Ⅱ期组及Ⅲ期组,DR Ⅱ期组及Ⅲ期组患者Chemerin水平均高于DR Ⅰ期组(P＜0.05).Logistic回归分析结果显示,收缩压高、TNF-α、IL-1 β、IL-6、NF-κB、CMKLR-1、Chemerin水平高均是影响DR患者病情的危险因素(P＜0.05).ROC曲线分析结果显示,CMKLR-1、Chemerin单独及二者联合检测评估增生型DR的AUC＞0.70,具有一定的评估价值.结论 趋化因子CMKLR-1、Chemerin在不同分期DR患者中的表达存在差异,且能为增生型DR的评估提供参考.
Abstract
Objective To investigate the expression and clinical significance of chemokines in patients with different stages of diabetic retinopathy(DR).Methods A total of 120 patients with DR treated in our hospital from April 2019 to December 2021 were selected and divided into DR Ⅰ group(11 cases),DR Ⅱ group(21 cases),DR Ⅲ group(28 cases),DR Ⅳ group(35 cases)and DR Ⅴ group(25 cases)according to the degree of retinopathy.DR Stage Ⅰ-Ⅲ was non-proliferative DR,and DR Stage Ⅳ-Ⅴ was proliferative DR.Baseline data,relevant laboratory examination indicators and chemokine levels[chemokine-like receptor 1(CMKLR-1),Chemerin]of patients in each group were collected and compared in groups.Logistic regression analysis was used to evaluate the factors affecting the severity of DR disease.The value of chemokines CMKLR-1 and Chemerin in evaluating the severity of DR disease was analyzed by receiver operating characteristic(ROC)curve.Results Systolic blood pressure of patients in DR Ⅳ and Ⅴ groups was higher than that in DR Ⅰ group,Ⅱ group and Ⅲ group;levels of tumor necrosis factor(TNF)-α,IL-1 β,IL-6,nuclear factor-Kb(NF-κB),CMKLR-1 and Chemerin in DRⅣ and Ⅴ groups were higher than those in DR Ⅰ group,Ⅱ group,Ⅲ group;level of Chemerin in DR Ⅱand Ⅲ groups were higher than that in DR Ⅰ group(P＜0.05).Results of logistic regression analysis showed that high systolic blood pressure,TNF-α,IL-1 β,IL-6,NF-κB,CMKLR-1 and Chemerin were risk factors for DR(P＜0.05).ROC curve analysis results showed that the AUC of CMKLR-1,Chemerin alone and their combination in the evaluation of proliferative DR was＞0.70,which had a certain evaluation value.Conclusion There are differences in the expression of chemokine CMKLR-1 and Chemerin in different stages of DR patients,and can provide reference for the evaluation of proliferative DR.
维普
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