Study on the Relationship among Serum FABP4,VWF and LCN-2 Expression,the Degree and Prognosis of Secondary Macular Edema in Patients with Retinal Vein Obstruction
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维普
万方数据
目的 探究视网膜静脉阻塞(retinal vein obstruction,RVO)患者血清脂肪细胞型脂肪酸结合蛋白(fatty acid-binding protein 4,FABP4)、血管性假血友病因子(von willebrand factor,VWF)、脂质运载蛋白 2(lipocalin-2,LCN-2)水平表达与继发黄斑水肿(macular edema,ME)程度及预后的关系研究.方法 选取2021年1月～2023年8月来西北大学附属第一医院治疗的98例确诊的RVO继发ME患者为观察组,根据黄斑水肿程度分为重度组(n=46)、中度组(n=32)和轻度组(n=20),根据预后情况分为预后不良组(n=36)和预后良好组(n=62);另选取98例单纯RVO患者为对照组.比较各组血清FABP4,VWF,LCN-2水平;多因素Logistic回归分析RVO继发ME患者发生预后不良的影响因素;ROC曲线分析血清FABP4,VWF和LCN-2水平对RVO继发ME患者发生预后不良的预测价值.结果 与对照组相比,观察组血清 FABP4(35.24±4.43 ng/ml vs 23.19±3.69 ng/ml),VWF(2.67±0.67 ng/ml vs 1.48±0.38 ng/ml),LCN-2(112.53±12.74 mg/L vs 85.49±9.86 mg/L)水平明显升高,差异具有统计学意义(t=20.690,15.294,16.616,均 P＜0.05);随病情逐渐发展,轻、中、重度组血清 FABP4(33.38±4.29 ng/ml,35.79±4.49 ng/ml,38.64±4.65 ng/ml),VWF(2.36±0.59ng/ml,2.72±0.66 ng/ml,3.29±0.87 ng/ml),LCN-2(105.84±12.24 mg/L,114.61±12.88 mg/L,124.59±13.69 mg/L)水平逐渐升高,差异具有统计学意义(F=10.194,13.294,15.703,均P＜0.05);与预后良好组相比,预后不良组血清 FABP4(39.64±4.59 ng/ml vs 32.69±4.34 ng/ml),VWF(3.26±0.87 ng/ml vs 2.33±0.55 ng/ml),LCN-2(124.56±13.42 mg/L vs 105.54±12.34 mg/L)水平明显升高,差异具有统计学意义(t=7.482,6.487,7.122,均 P＜0.05));血清 FABP4(OR=2.236,95％CI:1.109～4.510),VWF(OR=2.069,95％CI:1.044～4.100),LCN-2(OR=1.875,95％CI:1.015～3.463)为 RVO 继发ME 患者发生预后不良的独立危险因素(均P＜0.05);血清 FABP4,VWF,LCN-2 水平预测患者发生预后不良的 AUC(95％CI)分别为 0.817(0.726～0.888),0.791(0.697～0.867)和0.798(0.705～0.872),三者联合预测的AUC为0.932(0.863～0.973),三者联合预测优于各因子单独预测(Z=2.034,2.375,2.385,P=0.042,0.018,0.017).结论 RVO 继发 ME 患者血清 FABP4,VWF 和 LCN-2水平均上调,且均为患者发生预后不良的独立危险因素,三者联合检测对RVO继发ME患者发生预后不良具有更高的预测价值.
Objective To investigate the relationship among the expression of serum fatty acid-binding protein 4(FABP4),von willebrand factor(VWF)and lipocalin-2(LCN-2)with the degree of secondary macular edema(ME)and prognosis in patients with retinal vein obstruction(RVO).Methods From January 2021 to August 2023,98 confirmed patients with RVO secondary ME treated in the First Affiliated Hospital of Northwest University were regarded as the observation group.According to the degree of ME,they were grouped into severe group(n=46),moderate group(n=32)and mild group(n=20).According to the prognosis,they were grouped into poor prognosis group(n=36)and good prognosis group(n=62).Meanwhile,98 patients with simple RVO were assigned as the control group.The serum levels of FABP4,VWF and LCN-2 were compared and analyzed.Multivariate Logistic regression was applied to analyze the influencing factors of poor prognosis in patients with RVO secondary ME.ROC curve was applied to analyze the predictive value of serum FABP4,VWF and LCN-2 levels for poor prognosis in patients with RVO secondary ME.Results Compared with the control group,the serum FABP4(35.24±4.43 ng/ml vs 23.19±3.69 ng/ml),VWF(2.67±0.67 ng/ml vs 1.48±0.38 ng/ml),and LCN-2(112.53±12.74 mg/L vs 85.49±9.86 mg/L)in the observation group was elevated,and the differences were statistically significant(t=20.690,15.294,16.616,all P＜0.05).With the gradual progression of the disease,serum FABP4(33.38±4.29 ng/ml,35.79±4.49 ng/ml,38.64±4.65 ng/ml),VWF(2.36±0.59 ng/ml,2.72±0.66 ng/ml,3.29±0.87 ng/ml)and LCN-2(105.84±12.24 mg/L,114.61±12.88 mg/L,124.59±13.69 mg/L)were gradually increased,and the differences were significant(F=10.194,13.294,15.703,all P＜0.05).Compared with the good prognosis group,serum FABP4(39.64±4.59 ng/ml vs 32.69±4.34 ng/ml),VWF(3.26±0.87 ng/ml vs 2.33±0.55 ng/ml)and LCN-2(124.56±13.42 mg/L vs 105.54±12.34 mg/L)in the poor prognosis group,and the differences were statistically significant(t=7.482,6.487,7.122,all P＜0.05).Serum FABP4(OR=2.236,95％CI:1.109～4.510),VWF(OR=2.069,95％CI:1.044～4.100)and LCN-2(OR=1.875,95％CI:1.015～3.463)were independent risk factors for poor prognosis in patients with ME secondary to RVO(all P＜0.05).The AUC(95％)for predicting poor prognosis in patients with serum FABP4,VWF and LCN-2 levels were 0.817(0.726～0.888),0.791(0.697～0.867)and 0.798(0.705～0.872),respectively,and the AUC(95％CI)of the joint prediction of the three factors was 0.932(0.863～0.973).The joint prediction of the three factors was better than the individual prediction of each factor(Z=2.034,2.375,2.385,P=0.042,0.018,0.017).Conclusion The serum levels of FABP4,VWF and LCN-2 are all up-regulated in patients with secondary ME of RVO,and they are independent risk factors for poor prognosis.The combination of the three may have higher predictive value for poor prognosis in patients.
retinal vein obstructionfatty acid-binding protein 4von willebrand factorlipocalin-2macular edema
维普
万方数据
