血清Leptin、Apelin水平与增生型糖尿病性视网膜病变患者玻璃体切割术后视力残疾的关系  

Relationships between serum Leptin and Apelin levels and visual disability after vitrectomy in patients with proliferative diabetic retinopathy

作　　者：朱嘉丽 封月娟 刘钊[2] ZHU Jiali;FENG Yuejuan;LIU Zhao(Ophthalmology Department,The First Affiliated Hospital of Xi'an Jiao Tong University Yulin Hospital,Yulin 719000,China;不详)

机构地区：[1]西安交通大学第一附属医院榆林医院眼科,陕西榆林719000 [2]西安交通大学第一附属医院眼科

出　　处：《山东医药》2024年第31期10-14,共5页Shandong Medical Journal

基　　金：陕西省重点研发计划项目(2023-YBSF-568)。

摘　　要：目的探讨血清瘦素(Leptin)、爱帕琳肽(Apelin)水平与增生型糖尿病性视网膜病变(PDR)患者玻璃体切割术(PPV)后视力残疾的关系。方法选取接受PPV治疗的PDR患者198例(198眼),术后随访1年,根据是否发生视力残疾将患者分为视力残疾组48例、视力良好组150例。收集两组临床资料,术前用酶联免疫吸附试验检测血清Leptin、Apelin,多因素Logistic回归分析血清Leptin、Apelin水平对PDR患者PPV后视力残疾的影响,受试者工作特征(ROC)曲线分析血清Leptin、Apelin水平对PDR患者PPV后视力残疾的预测价值。结果与视力良好组比较,视力残疾组年龄大,PDR程度、术前虹膜新生血管比例、糖化血红蛋白水平及血清Leptin、Apelin水平高(P均<0.05)。多因素Logistic回归分析结果显示,重度PDR、术前虹膜新生血管、Leptin升高、Apelin升高为PDR患者PPV后视力残疾的独立危险因素(P均<0.05)。ROC曲线分析显示,血清Leptin、Apelin联合预测PDR患者PPV后视力残疾的曲线下面积为0.921,大于二者单独预测的曲线下面积(P均<0.05)。结论血清Leptin、Apelin水平升高是PDR患者PPV后视力残疾的危险因素,二者联合检测对PDR患者PPV后视力残疾的预测价值较高。Objective To investigate the relationships of serum Leptin and Apelin levels with visual disability after vitrectomy(PPV)in patients with proliferative diabetic retinopathy(PDR).Methods Totally 198 patients(198 eyes)with PDR treated with PPV were selected and followed up for 1 year after PPV,and the patients were divided into the visu⁃al disability group of 48 cases and the sighted group of 150 cases according to the occurrence of visual disability.Clinical data of the two groups were collected;3 mL of fasting elbow vein blood was collected from PDR patients before PPV treat⁃ment,and serum Leptin and Apelin were detected by enzyme-linked immunosorbent assay;the effects of serum Leptin and Apelin levels on visual disability after PPV in PDR patients were analyzed by multifactorial Logistic regression.The predic⁃tive value of serum Leptin and Apelin levels on visual disability after PPV in PDR patients was analyzed by the receiver op⁃erating characteristic(ROC)curve.Results Compared with the sighted group,the visual disability group was older and had higher degree of PDR,proportion of preoperative iris neovascularization,glycated hemoglobin levels and serum Leptin and Apelin levels(all P<0.05).The results of multifactorial Logistic regression analysis showed that severe PDR,preop⁃erative iris neovascularization,elevated Leptin,and elevated Apelin were independent risk factors for visual disability af⁃ter PPV in patients with PDR(all P<0.05).The ROC curve showed that the area under the curve of serum Leptin and Apelin combined in predicting visual disability after PPV in PDR patients was 0.921,which was greater than that of either alone(both P<0.05).Conclusion Elevated serum Leptin and Apelin levels are risk factors for post-PPV visual disabili⁃ty in patients with PDR,and the combination of the two has a high predictive value for post-PPV visual disability in pa⁃tients with PDR.

关 键 词：增生型糖尿病性视网膜病变 瘦素 爱帕琳肽 玻璃体切割术 视力残疾 

分 类 号：R774[医药卫生—眼科] R587.2[医药卫生—临床医学]