VEGF、AQP1、microRNA-21对糖尿病黄斑水肿抗VEGF药物治疗效果欠佳的预测价值  

Predictive value of VEGF,AQP1,and microRNA-21 for the poor outcome of anti-VEGF drug therapy in diabetic macular edema

作　　者：霍楠[1] 赵军波[1] 王敏[2] 安伟乔[3] 尹晓玲[1] 

机构地区：[1]邯郸市中心医院眼科,河北邯郸056001 [2]邯郸市中心医院感染性疾病科,河北邯郸056001 [3]邯郸市中心医院老年病科,河北邯郸056001

出　　处：《医学前沿》2024年第9期34-38,共5页Frontiers of Medicine

基　　金：邯郸市科学技术研究与发展计划项目(21422083122)。

摘　　要：目的探讨血管内皮生长因子(VEGF)、水通道蛋白1(AQP1)、微小核糖核酸-21(microRNA-21)对糖尿病黄斑水肿(DME)抗VEGF药物治疗效果欠佳的预测价值。方法选取2019年4月~2022年4月我院收治的200例DME为研究对象,均进行抗VEGF药物玻璃体注射治疗,根据治疗5个月后疗效将患者分为治疗效果良好组和治疗效果欠佳组。检测并比较治疗前后VEGF、AQP1、microRNA-21水平,对比不同治疗效果患者一般资料,分析影响DME抗VEGF药物治疗效果欠佳的危险因素和VEGF、AQP1、microRNA-21对治疗效果欠佳患者的预测价值。结果经抗VEGF药物治疗5个月后,200例DME患者中,治疗效果不佳31例,占比15.5%。治疗后,DME患者VEGF、AQP1、microRNA-21水平均低于治疗前(P<0.05)。DME患者年龄、DME病程、DME分期、渗透程度、黄斑中心凹视网膜厚度、VEGF、AQP1、microRNA-21与抗VEGF药物治疗DME的效果有关(P<0.05)。VEGF、AQP1、microRNA-21是抗VEGF药物治疗DME效果欠佳的独立影响因素(P<0.05)。VEGF、AQP1、microRNA-21及联合对抗VEGF药物治疗DME效果欠佳的曲线下面积(AUC)为0.617、0.884、0.797、0.920,联合预测的AUC高于VEGF、microRNA-21(z=4.809、2.895,P<0.05)。结论VEGF、AQP1、microRNA-21是DME抗VEGF药物治疗效果欠佳的影响因素,对治疗效果欠佳具有一定预测价值。Objective To investigate the predictive value of vascular endothelial growth factor(VEGF),aquaporin 1(AQP1),and microRNA-21(microRNA-21)for the poor outcome of anti-VEGF drug therapy in diabetic macular edema(DME).Methods Two hundred cases of DME admitted to our hospital from April 2019 to April 2022 were selected for the study,all of which were treated with anti-VEGF drug vitreous injection,and the patients were divided into the group with good treatment effect and the group with poor treatment effect according to the efficacy after 5 months of treatment.The levels of VEGF,AQP1,and microRNA-21 were measured and compared before and after treatment,and the general data of patients with different treatment effects were compared to analyze the risk factors affecting the poor treatment effect of anti-VEGF drugs in DME and the predictive value of VEGF,AQP1,and microRNA-21 for patients with poor treatment effect.Results After 5 months of treatment with anti-VEGF drugs,31(15.5%)of the 200 patients with DME had a poor treatment outcome.After treatment,VEGF,AQP1,and microRNA-21 levels were lower in patients with DME than before treatment(P<0.05).Age,duration of DME,stage of DME,degree of penetration,retinal thickness of the central macular sulcus,VEGF,AQP1,and microRNA-21 were associated with the effectiveness of anti-VEGF drugs for the treatment of DME in patients with DME(P<0.05).VEGF,AQP1,and microRNA-21 were independent influencing factors for the poor outcome of anti-VEGF drugs for DME(P<0.05).The area under the curve(AUC)of VEGF,AQP1,microRNA-21,and combined anti-VEGF drugs for the less effective treatment of DME was 0.617,0.884,0.797,and 0.920,and the AUC predicted by the combination was higher than that of VEGF and microRNA-21(z=4.809,2.895,P<0.05).Conclusion VEGF,AQP1,and microRNA-21 are influential factors for the poor treatment effect of anti-VEGF drugs in DME and have some predictive value for the poor treatment effect.

关 键 词：糖尿病 糖尿病黄斑水肿 雷珠单抗 血管内皮生长因子 水通道蛋白1 微小核糖核酸-21 

分 类 号：R73[医药卫生—肿瘤]