新生血管性青光眼患者房水HGF、ENA78及Sema3A的变化及临床意义  

Changes and clinical significance of HGF,ENA78,and Sema3A in aqueous humor of patients with neovascular glaucoma

作　　者：吴祎林 李光辉 衡欣 WU Yi-lin;LI Guang-hui;HENG Xin(Department of Ophthalmology,Xuchang People's Hospital,Xuchang 461000,Henan,CHINA)

机构地区：[1]许昌市人民医院眼科,河南许昌461000

出　　处：《海南医学》2024年第3期385-389,共5页Hainan Medical Journal

基　　金：河南省自然科学基金(编号:222300430165)。

摘　　要：目的检测新生血管性青光眼(NVG)患者房水中肝细胞生长因子(HGF)、中性粒细胞激活肽-78(ENA78)及信号素3A(Sema3A)的水平,并探讨其临床意义。方法选取2018年1月至2023年1月许昌市人民医院收治的80例NGF患者作为观察组,均采用抗血管内皮生长因子(VEGF)治疗,其中治疗有效患者66例,治疗无效患者14例。另选取单纯行白内障手术的80例患者作为对照组。比较两组患者房水中HGF、ENA78及Sema3A水平,比较观察组抗VEGF治疗有效与无效患者临床资料及房水中HGF、ENA78、Sema3A水平,采用多因素Logistic回归分析NVG患者抗VEGF疗效的影响因素,采用受试者工作特征曲线(ROC)评价房水中HGF、ENA78及Sema3A对NVG患者抗VEGF疗效的预测价值。结果观察组患者房水中HGF、ENA78及Sema3A分别为(847.56±128.41)ng/L、(185.36±25.41)ng/mL、(2.04±0.85)ng/mL,明显高于对照组的(488.92±98.25)ng/L、(84.29±17.37)ng/mL、(0.68±0.29)ng/mL,差异均有统计学意义(P<0.05);抗VEGF治疗有效与无效患者的一般资料比较差异均无统计学意义(P>0.05),抗VEGF治疗无效患者房水中HGF、ENA78及Sema3A分别为(974.22±154.33)ng/L、(218.83±31.22)ng/mL、(3.02±0.98)ng/mL,明显高于治疗有效患者的(820.69±118.21)ng/L、(178.26±18.33)ng/mL、(1.83±0.82)ng/mL,差异均有统计学意义(P<0.05);经多因素Logistic回归分析结果显示,房水中HGF、ENA78及Sema3A水平升高均为影响NVG患者抗VEGF疗效的危险因素(P<0.05);经ROC曲线分析结果显示,房水中HGF、ENA78及Sema3A联合检测预测NVG患者抗VEGF疗效的曲线下面积(AUC)值为0.921,明显高于房水中HGF、ENA78及Sema3A单独预测,差异均有统计学意义(P<0.05)。结论NVG患者房水中HGF、ENA78及Sema3A水平异常升高,且其为抗VEGF疗效的独立危险因素,检测三者水平有助于预测NVG患者抗VEGF疗效,为临床医师判断疾病治疗效果提供参考。Objective To detect the levels of hepatocyte growth factor(HGF),neutrophil-activating peptide-78(ENA78),and semaphorin 3A(Sema3A)in the aqueous humor of patients with neovascular glaucoma(NVG),and to explore their clinical significance.Methods A total of 80 patients with NGF admitted to the Xuchang People's Hospital from January 2018 to January 2023 were selected as the observation group,all of whom were treated with anti-VEGF therapy,including 66 patients who responded effectively to treatment and 14 patients who did not respond effectively.A total of 80 patients who underwent cataract surgery alone were selected as the control group.The levels of HGF,ENA78,and Sema3A in the aqueous humor of the two groups of patients were compared.The clinical data and the levels of HGF,ENA78,and Sema3A in the aqueous humor of the patients in the observation group who responded effectively and ineffective to anti-VEGF therapy were compared.Multivariate logistic regression analysis was used to analyze the influencing factors of the anti-VEGF efficacy in NVG patients,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of HGF,ENA78,and Sema3A in the aqueous humor for the anti-VEGF efficacy in NVG patients.Results The levels of HGF,ENA78,and Sema3A in the aqueous humor of the observation group were(847.56±128.41)ng/L,(185.36±25.41)ng/mL,and(2.04±0.85)ng/mL,respectively,significantly higher than(488.92±98.25)ng/L,(84.29±17.37)ng/mL,and(0.68±0.29)ng/mL of the control group(P<0.05).There was no statistically significant difference in the general data between patients who responded effectively and those who did not respond effectively to anti-VEGF therapy(P>0.05).The levels of HGF,ENA78,and Sema3A in the aqueous humor of patients who did not respond effectively to anti-VEGF treatment were(974.22±154.33)ng/L,(218.83±31.22)ng/mL,and(3.02±0.98)ng/mL,respectively,significantly higher than(820.69±118.21)ng/L,(178.26±18.33)ng/mL,and(1.83±0.82)ng/mL in patients who responded effectively(P<

关 键 词：新生血管性青光眼 糖尿病 肝细胞生长因子 中性粒细胞激活肽-78 信号素3A 临床意义 

分 类 号：R775[医药卫生—眼科]