机构地区:[1]山阳县人民医院五官科,陕西商洛726400 [2]白河县人民医院眼科,陕西安康725899
出 处:《医学临床研究》2023年第3期403-406,共4页Journal of Clinical Research
摘 要:【目的】探讨补体因子H(CFH)、补体C5b-9与年龄相关性黄斑变性(AMD)患者视力预后的相关性。【方法】选取2018年4月至2021年3月山阳县人民医院收治的136例AMD患者,统计患者治疗3个月后的视力预后情况,并依据视力预后情况分为预后不良组和预后良好组。对比预后不良组和预后良好组的临床资料;Logistic多因素回归分析影响AMD患者视力预后的有关因素;采用受试者工作特征(ROC)曲线分析联合检测CFH、补体C5b-9对AMD患者视力预后不良的预测价值。【结果】AMD患者视力预后不良发生率为35.29%。预后不良组年龄、病灶面积(CSA)、血流面积(CFA)、凹视网膜厚度(CMT)及补体C5b-9水平均高于预后良好组(P<0.05),CFH则低于预后良好组(P<0.05)。Logistic回归分析结果显示:CFA、CFH及补体C5b-9均是影响AMD患者视力预后的危险因素(OR=2.742、3.330、3.019,P<0.05)。ROC曲线分析显示:CFH、补体C5b-9预测AMD患者视力预后不良的最佳截断点分别为254.07 ng/mL、73.69 ng/mL,两者联合的特异度为97.73%,高于CFH、补体C5b-9单独评估的特异度,且CFH、补体C5b-9两者联合预测AMD患者视力预后不良的曲线下面积(AUC)为0.893,高于CFH、补体C5b-9单独预测的AUC(P<0.05)。【结论】CFH、补体C5b-9两者联合对AMD患者视力预后不良的预测效能较高,可作为临床评估AMD患者视力预后的重要参考指标。【Objective】To investigate the correlation between complement factor H(CFH),complement C5b-9,and visual prognosis in patients with age related macular degeneration(AMD).【Methods】A total of 136 patients with AMD admitted to the Shanyang County People's Hospital from April 2018 to March 2021 were selected,and their visual prognosis after 3 months of treatment was statistically analyzed.They were divided into poor prognosis group and good prognosis group based on their visual prognosis.The clinical data of the poor prognosis group and the good prognosis group were compared;Logistic multivariate regression analysis was used to analyze the related factors affecting the visual prognosis of AMD patients.The predictive value of combined detection of CFH and complement C5b-9 in predicting poor visual prognosis in patients with AMD using the receiver operating characteristic(ROC)curve analysis.【Results】The incidence of poor visual prognosis in AMD patients was 35.29%.The age,focal area(CSA),blood flow area(CFA),concave retinal thickness(CMT),and complement C5b-9 in the poor prognosis group were higher than those in the good prognosis group(P<0.05),while CFH was lower than those in the good prognosis group(P<0.05).Logistic regression analysis showed that CFA,CFH,and complement C5b-9 were all risk factors affecting visual prognosis in patients with AMD(OR=2.742,3.330,3.019,P<0.05).The ROC curve analysis showed that the best cutoff points for predicting poor visual prognosis in AMD patients with CFH and complement C5b-9 were 254.07 ng/mL and 73.69 ng/mL,respectively.The specificity of the combination of CFH and complement C5b-9 was 97.73%,which was higher than the specificity of the independent evaluation of CFH and complement C5b-9.The area under the curve(AUC)for predicting poor visual prognosis in AMD patients with CFH and complement C5b-9 was 0.893,which was higher than the AUC predicted by CFH and complement C5b-9 alone(P<0.05).【Conclusion】The combination of CFH and complement C5b-9 is highly effective in
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