血清VEGF、HPSE、HIF-1α与视网膜中央静脉阻塞患者雷珠单抗治疗后视力预后的关系  

Relationship between Serum VEGF,HPSE,HIF-1α and Visual Prognosis in Patients with Central Retinal Vein Occlusion after Ranibizumab Treatment

作　　者：钱光霞 刘圣慧 杨晓梅 陈鑫 杨主敏 QIAN Guang-xia;LIU Sheng-hui;YANG Xiao-mei;CHEN Xin;YANG Zhu-min(Department of Ophthalmology,Affiliated Hospital of Guizhou Medical University,Guiyang,Guizhou,550004,China;Department of Ophthalmology,Baiyun Hospital Affiliated to Guizhou Medical University,Guiyang,Guizhou,550014,China;Graduate School of Guizhou Medical University,Guiyang,Guizhou,550000,China)

机构地区：[1]贵州医科大学附属医院眼科,贵州贵阳550004 [2]贵州医科大学附属白云医院眼科,贵州贵阳550014 [3]贵州医科大学研究生院,贵州贵阳550000

出　　处：《现代生物医学进展》2024年第9期1702-1706,1759,共6页Progress in Modern Biomedicine

基　　金：贵州省科技局项目(黔科LH字[2017]7212号);贵阳市白云区科技局项目(白科合同[2020]8号)。

摘　　要：目的:研究血清血管内皮生长因子(VEGF)、乙酰肝素酶(HPSE)、低氧诱导因子1α(HIF-1α)与视网膜中央静脉阻塞(CRVO)患者雷珠单抗治疗后视力预后的关系。方法:选取2020年1月-2022年8月贵州医科大学附属医院眼科收治的145例CRVO患者,根据雷珠单抗治疗后视力预后状况分为预后良好组(n=104)和预后不良组(n=41)。比较预后良好组和预后不良组临床资料及血清VEGF、HPSE、HIF-1α水平。采用多因素Logistic回归模型分析CRVO患者雷珠单抗治疗后视力预后的影响因素,采用受试者工作特征(ROC)曲线分析血清VEGF、HPSE、HIF-1α对CRVO患者雷珠单抗治疗后视力预后的预测价值。结果:与预后良好组相比,预后不良组的年龄、缺血型CRVO占比、合并高血压占比、合并高脂血症占比、持续黄斑水肿占比及血清VEGF、HPSE、HIF-1α水平更高,同时CRVO病程更长,初诊最佳矫正视力更低(均P<0.05);多因素Logistic回归分析显示初诊最佳矫正视力低、持续黄斑水肿、缺血型CRVO及血清VEGF、HPSE、HIF-1α升高是CRVO患者雷珠单抗治疗后视力预后不良的危险因素(P<0.05);血清VEGF、HPSE、HIF-1α单独和联合预测CRVO患者雷珠单抗治疗后视力预后的曲线下面积(AUC)分别为0.726、0.777、0.836、0.891,联合预测的效能显著优于单项检测(P<0.05)。结论:CRVO患者血清VEGF、HPSE、HIF-1α水平越高,雷珠单抗治疗后视力预后状况越差。三项指标联合预测CRVO患者雷珠单抗治疗后视力预后的价值较高,有望作为CRVO预后评估指标。Objective:To study the relationship between serum vascular endothelial growth factor(VEGF),heparanase(HPSE),hypoxia inducible factor-1α(HIF-1α)and visual prognosis in patients with central retinal vein occlusion(CRVO)after ranibizumab treatment.Methods:145 CRVO patients admitted to the Department of Ophthalmology,Affiliated Hospital of Guizhou Medical University from January 2020 to August 2022 were selected,patients were divided into good prognosis group(n=104)and poor prognosis group(n=41)according to the visual prognosis situation after ranibizumab treatment.The clinical data and serum levels of VEGF,HPSE and HIF-1α were compared between good prognosis group and poor prognosis group.The influencing factors of visual prognosis after ranibizumab treatment in CRVO patients were analyzed by multivariate Logistic regression model,the predictive value of serum VEGF,HPSE and HIF-1α on the visual prognosis of CRVO patients after ranibizumab treatment was analyzed by receiver operating characteristic(ROC)curve.Results:Compared with the good prognosis group,the age,the proportion of ischemic type CRVO,the proportion of combined with hypertension,the proportion of combined with hyperlipidemia,the proportion of persistent macular edema and serum VE GF,HPSE,HIF-1α levels were higher in the poor prognosis group,and course of CRVO was longer,and the best corrected visual acuity at initial diagnosis was lower(all P<0.05).Multivariate logistic regression analysis showed that low best corrected visual acuity at initial diagnosis,persistent macular edema,ischemic type CRVO and elevated serum VEGF,HPSE and HIF-1α were risk factors for poor visual prognosis in CRVO patients after ranibizumab treatment(P<0.05).The area under the curve(AUC)of serum VEGF,HPSE and HIF-1α alone and in combination in predicting the visual prognosis of CRVO patients after ranibizumab treatment was 0.726,0.777,0.836 and 0.891 respectively,the efficacy of combined prediction was significantly better than that of single detection(P<0.05).Conclusion:I

关 键 词：VEGF HPSE HIF-1Α 视网膜中央静脉阻塞 雷珠单抗 视力预后 

分 类 号：R774[医药卫生—眼科]