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

作　　者：李亚楠 贾洪强 魏素平 赵骏 LI Ya’nan;JIA Hongqiang;WEI Suping;ZHAO Jun(Department of Ophthalmology,Cangzhou Eye Hospital,Hebei Cangzhou 061000,China;Department of Fundus Disease,Cangzhou Eye Hospital,Hebei Cangzhou 061000,China;Department of Clinical Laboratory,Cangzhou Eye Hospital,Hebei Cangzhou 061000,China;Department of Function,Cangzhou Eye Hospital,Hebei Cangzhou 061000,China)

机构地区：[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

出　　处：《现代检验医学杂志》2024年第1期78-82,111,共6页Journal of Modern Laboratory Medicine

基　　金：河北省2022年度医学科学研究课题计划,编号(20220403):青光眼引流器植入术对复杂型青光眼患者眼表影响。

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±4.63ng/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。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 clin

关 键 词：信号转导和转录激活因子3 SMAD4 原发性青光眼 

分 类 号：R775.2[医药卫生—眼科] R392.11[医药卫生—临床医学]