现代检验医学杂志2024，Vol.39Issue(1) ：78-82,111.DOI:10.3969/j.issn.1671-7414.2024.01.014

原发性青光眼患者血清STAT3和SMAD4水平表达在临床早期诊断及分期中的应用价值研究

Application Value of Serum STAT3 and SMAD4 Expression Levels in Early Diagnosis and Staging of Primary Glaucoma Patients

李亚楠 贾洪强 魏素平 赵骏
现代检验医学杂志2024，Vol.39Issue(1) ：78-82,111.DOI:10.3969/j.issn.1671-7414.2024.01.014
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原发性青光眼患者血清STAT3和SMAD4水平表达在临床早期诊断及分期中的应用价值研究

Application Value of Serum STAT3 and SMAD4 Expression Levels in Early Diagnosis and Staging of Primary Glaucoma Patients

李亚楠 1贾洪强 2魏素平 3赵骏4
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作者信息

  • 1. 沧州市眼科医院眼科,河北沧州 061000
  • 2. 沧州市眼科医院眼底病科,河北沧州 061000
  • 3. 沧州市眼科医院检验科,河北沧州 061000
  • 4. 沧州市眼科医院功能科,河北沧州 061000
  • 折叠

摘要

目的 探究血清信号转导和转录激活因子 3(signal transducer and activator of transcription 3,STAT3),SMAD4 水平表达在原发性青光眼(primary glaucoma)患者早期诊断及临床分期中的应用价值.方法 选取沧州市眼科医院 2021 年 8 月～2023 年 5 月收治的原发性青光眼患者 86 例作为研究组,依据研究组临床症状和视力检查结果分为轻度损伤期(n=30)、中度损伤期(n=34)和重度损伤期(n=22);另选取同期在该院进行体检的健康正常者 86 例作为对照组.采用酶联免疫吸附法(ELISA)检测血清STAT3 和SMAD4 表达水平;多因素Logistic回归分析影响原发性青光眼临床分期的相关因素;受试者工作特征(ROC)曲线分析血清STAT3 和SMAD4 对原发性青光眼中/重度损伤期患者的诊断价值.结果 研究组血清STAT3(13.96±3.45 ng/ml)和SMAD4(11.23±2.85 ng/ml)表达水平均显著高于对照组(9.83±1.72 ng/ml,7.78±1.95 ng/ml),差异有统计学意义(t=9.935,9.265,均P＜0.05).轻度损伤期、中度损伤期和重度损伤期组原发性青光眼患者血清STAT3(11.88±2.52 ng/ml,13.85±3.51 ng/ml,16.96±4.63 ng/ml)和SMAD4(9.15±1.95 ng/ml,11.23±2.83 ng/ml,14.08±4.12 ng/ml)表达水平均逐渐升高,差异具有统计学意义(F=13.085,17.513,均P＜0.05).轻度损伤期、中度损伤期和重度损伤期患者眼压(24.21±5.03 mmHg,28.16±6.31 mmHg,32.26±7.57 mmHg)比较,差异有统计学意义(F=10.577,P＜0.05).血清STAT3[OR(95%CI)= 2.728(1.409～5.281)],SMAD4[OR(95%CI)=2.849(1.507～5.387)],眼压[OR(95%CI)=2.435(1.094～5.417)]为影响原发性青光眼临床分期的危险因素(均P＜0.05).血清STAT3,SMAD4 二者联合诊断原发性青光眼中/重度损伤期患者的曲线下面积(AUC)为0.963(95%CI:0.899～0.992),优于各自单独诊断(Z =2.558,1.961,P=0.010,0.049),其灵敏度和特异度分别为 96.43%,83.33%.结论 血清STAT3 和SMAD4 表达水平越高患者临床症状越严重,二者联合检测对中/重度损伤期患者有较好的诊断价值.

Abstract

Objective To explore the application of serum signal transducers and activators of transduction 3(STAT3)and SMAD4 expression levels in the early diagnosis and clinical staging of primary glaucoma patients.Methods 86 patients with primary glaucoma admitted to Cangzhou Eye Hospital from August 2021 to May 2023 were selected as the study group,according to the clinical symptoms and visual examination results of the research group,they were divided into mild injury stage(n=30),moderate injury stage(n=34)and severe injury stage(n=22).Another 86 healthy individuals who underwent physical examinations in Cangzhou Eye Hospital during the same period were collected as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to detect the expression levels of serum STAT3 and SMAD4.Multivariate Logistic regression was applied to analyze the relevant factors affecting clinical staging of primary glaucoma,receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum STAT3 and SMAD4 in patients with moderate/severe primary glaucoma injury.Results The expression levels of serum STAT3(13.96±3.45 ng/ml)and SMAD4(11.23±2.85 ng/ml)in the study group were obviously higher than those in the control group(9.83±1.72 ng/ml,7.78±1.95 ng/ml),the differences were statistically significant(F=13.085,17.513,all P＜0.05).The expression levels of serum STAT3(11.88±2.52 ng/ml,13.85±3.51 ng/ml,16.96±4.63 ng/ml)and SMAD4(9.15±1.95 ng/ml,11.23±2.83 ng/ml,14.08±4.12 ng/ml)in patients with primary glaucoma in mild,moderate and severe injury groups were gradually increased,the differences were statistically significant(F=13.085,17.513,all P＜0.05).There was a statistically obvious difference in intraocular pressure among patients with mild,moderate(24.21±5.03 mmHg,28.16±6.31 mmHg,32.26±7.57mmHg),and severe injuries(F=10.577.P＜0.05).serum STAT3[OR(95%CI)=2.728(1.409～5.281)],SMAD4[OR(95%CI)=2.849(1.507～5.387)],and intraocular pressure[OR(95%CI)=2.435(1.094～5.417)]were risk factors affecting clinical staging of primary glaucoma(all P＜0.05).The area under the curve(AUC)of the combined diagnosis of serum STAT3 and SMAD4 for moderate/severe injury in patients with primary glaucoma was 0.963(95%CI:0.899～0.992),which was superior to their respective individual diagnoses(Z =2.558,1.961;P=0.010,0.049),their sensitivity and specificity were 96.43%and 83.33%,respectively.Conclusion The higher the expression levels of STAT3 and SMAD4 in serum,the more severe the clinical symptoms in patients.The combined detection of the two has good diagnostic value for patients with moderate/severe injury.

关键词

信号转导和转录激活因子3/SMAD4/原发性青光眼

Key words

signal transducers and activators of transduction 3/SMAD4/primary glaucoma

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基金项目

河北省医学科学研究项目(2022)(20220403)

出版年

2024
现代检验医学杂志
陕西省临床检验中心,陕西省人民医院

现代检验医学杂志

CSTPCD
影响因子：0.713
ISSN：1671-7414
参考文献量10
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