糖尿病视网膜病变患者血清BMP4、Netrin-4水平与病情分期及预后的关系研究  

Relationship between serum BMP4 and Netrin-4 levels and disease stage and prognosis in patients with diabetic retinopathy

作　　者：彭祖江 曹朝霞 曾芳馨[1] 王龙英 唐倩 PENG Zujiang;CAO Chaoxia;ZENG Fangxin;WANG Longying;TANG Qian(Department of Endocrinology and Metabolism,Dazhou Integrated TCM&Western Medicine Hospital,Dazhou,Sichuan 635002,China;Department of Clinical Laboratory,Dazhou Integrated TCM&Western Medicine Hospital,Dazhou,Sichuan 635002,China;Department of Ophthalmology,Dazhou Integrated TCM&Western Medicine Hospital,Dazhou,Sichuan 635002,China)

机构地区：[1]达州市中西医结合医院内分泌代谢科,四川达州635002 [2]达州市中西医结合医院检验科,四川达州635002 [3]达州市中西医结合医院眼科,四川达州635002

出　　处：《国际检验医学杂志》2024年第20期2515-2519,共5页International Journal of Laboratory Medicine

基　　金：达州市科技计划项目(21CYRC0002)。

摘　　要：目的分析糖尿病视网膜病变(DR)患者血清骨形态发生蛋白4(BMP4)、神经轴突导向因子4(Netrin-4)水平,并研究其与患者病情分期及预后的关系。方法选取2019年10月至2022年11月该院收治的186例2型糖尿病患者作为研究对象,依据是否发生视网膜病变分为DR组(108例)和非DR组(78例),同期选取该院100例体检健康者作为对照组。依据DR患者病情分期将DR患者分为Ⅰ期(19例),Ⅱ期(14例),Ⅲ期(22例),Ⅳ期(23例),Ⅴ期(18例),Ⅵ期(12例),依据DR患者治疗后的视力残疾情况分为预后良好组(72例)及预后不良组(36例)。采用酶联免疫吸附试验检测血清BMP4、Netrin-4、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平,分析不同病情分期DR患者血清BMP4、Netrin-4水平。采用多因素Logistic回归分析DR发生的影响因素,分析不同预后DR患者血清BMP4、Netrin-4水平,采用受试者工作特征(ROC)曲线分析DR患者预后不良的诊断价值。结果DR组FPG、HbA1c、SBP、DBP、TG、TC、BMP4、Netrin-4水平高于对照组及非DR组,HDL-C水平低于对照组及DR组(P<0.05)。不同病情分期DR患者血清BMP4、Netrin-4水平比较,差异有统计学意义(P<0.05)。HbA1c、BMP4及Netrin-4水平是DR发生的影响因素(P<0.05)。预后不良组血清BMP4、Netrin-4水平高于预后良好组(P<0.05)。血清BMP4、Netrin-4水平联合诊断DR患者预后不良的效能优于各指标单独诊断。结论DR患者血清BMP4、Netrin-4水平升高,可辅助评估患者病情分期,联合诊断患者预后不良的效果较好。Objective To analyze the serum levels of bone morphogenetic protein 4(BMP4)and nerve axon guidance factor 4(Netrin-4)in patients with diabetic retinopathy(DR),and to study their relationship with disease stage and prognosis.Methods A total of 186 patients with type 2 diabetes admitted to the hospital from October 2019 to November 2022 were selected as the research objects.According to the presence or absence of retinopathy,they were divided into DR Group(108 cases)and non-DR group(78 cases),and 100 healthy people in the hospital were selected as the control group.According to the stage of DR,the DR patients were divided into stageⅠ(19 cases),stageⅡ(14 cases),stageⅢ(22 cases),stageⅣ(23 cases),stageⅤ(18 cases)and stageⅥ(12 cases).According to the visual impairment after treatment,the DR patients were divided into a good prognosis group(72 cases)and a poor prognosis group(36 cases).Serum BMP4,Netrin-4,fasting plasma glucose(FPG),glycated hemoglobin A1c(HbA1c),systolic blood pressure(SBP),diastolic blood pressure(DBP),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)were detected by enzyme-linked immunosorbent assay.The serum levels of BMP4 and Netrin-4 in DR patients with different disease stages were analyzed.Multivariate Logistic regression was used to analyze the influencing factors of DR,and the serum levels of BMP4 and Netrin-4 in DR patients with different prognosis were analyzed.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of poor prognosis in DR patients.Results The FPG,HbA1c,SBP,DBP,TG,TC,BMP4,Netrin-4 levels in DR group were higher than those in control group and non-DR group,while HDL-C level was lower than that in control group and DR group(P<0.05).There were significant differences in serum BMP4 and Netrin-4 levels between DR patients with different disease stages(P<0.05).HbA1c,BMP4 and Netrin-4 levels were influencing factors for the occurrence of DR(P<0.05).The serum leve

关 键 词：糖尿病视网膜病变 骨形态发生蛋白4 神经轴突导向因子4 病情分期 预后 

分 类 号：R587.2[医药卫生—内分泌]