血清不对称二甲基精氨酸、神经丝蛋白轻链水平与早产儿视网膜病变严重程度及预后的关系  

Relationship between serum asymmetric dimethylarginine,neurofilament protein light chain levels and the degree of severity and prognosis of retinopathy of prematurity

作　　者：蒋晨[1] 宋艳[1] 王绍飞[1] 丁琳[1] JIANG Chen;SONG Yan;WANG Shaofei;DING Lin(Department of Ophthalmology,People’s Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Uygur Autonomous Region,Urumqi830002,China)

机构地区：[1]新疆维吾尔自治区人民医院眼科,新疆乌鲁木齐830002

出　　处：《中国医药导报》2025年第5期127-131,共5页China Medical Herald

基　　金：新疆维吾尔自治区自然科学基金资助项目(面上项目)(2021D01C150)。

摘　　要：目的探讨血清不对称二甲基精氨酸(ADMA)、神经丝蛋白轻链(NfL)水平与早产儿视网膜病变(ROP)严重程度及预后的关系。方法选择2020年12月至2023年12月新疆维吾尔自治区人民医院眼科收治的88例ROP患儿,根据ROP病情将患儿分为轻度组(46例)和中重度组(42例)。所有患儿接受视网膜激光光凝治疗,出院后定期复诊,根据ROP预后将患儿分为恶化组(13例)和好转组(75例)。检测患儿血清ADMA、NfL水平,分析ADMA、NfL与ROP病情严重程度及预后的关系,评估ADMA、NfL对ROP预后的价值。结果中重度组血清ADMA、NfL水平均高于轻度组(P<0.05)。恶化组血清ADMA、NfL水平均高于好转组(P<0.05)。恶化组与好转组出生体重、ROP分级、接受冷冻治疗、急进性后极部早产儿视网膜病变(AP-ROP)比较,差异有统计学意义(P<0.05)。AP-ROP(OR=3.762)、ADMA(OR=2.079)、NfL(OR=1.845)是ROP病情恶化的危险因素(P<0.05)。对混杂因素校正后,ADMA、NfL仍与ROP病情恶化有关。ADMA联合NfL预测ROP病情恶化的曲线下面积高于各指标单独预测(P<0.05)。结论ROP患儿血清ADMA、NfL水平增高与病情加重和恶化进展有关,可作为ROP预后的标志物。Objective To investigate the relationship between serum asymmetric dimethylarginine(ADMA),neurofilament protein light chain(NfL)levels and the degree of severity and prognosis of retinopathy of prematurity(ROP).Methods A total of 88 ROP children admitted to the Department of ophthalmology,People’s Hospital of Xinjiang Uygur Autonomous Region from December 2020 to December 2023 were selected.According to the condition of ROP,the children were divided into mild group(46 cases)and moderate to severe group(42 cases).All children were treated with retinal laser photocoagulation,revisited regular outpatient follow-up after discharge.According to the prognosis of ROP,the children were divided into deterioration group(13 cases)and improvement group(75 cases).The levels of serum ADMA and NfL were detected,and the relationship between ADMA,NfL and the the degree of severity and prognosis of ROP were analyzed,and the prognostic value of ADMA and NfL in ROP were evaluated.Results The levels of serum ADMA and NfL in moderate to severe group were higher than those in mild group(P<0.05).The levels of serum ADMA and NfL in deterioration group were higher than those in improvement group(P<0.05).There were significant differences in birth weight,ROP grade,receiving cryotherapy,and aggressive posterior retinopathy of prematurity(AP-ROP)between deteriorated group and improvement group(P<0.05).AP-ROP(OR=3.762),ADMA(OR=2.079),and NfL(OR=1.845)were risk factors for the deterioration of ROP(P<0.05).After adjusting for confounding factors,ADMA and NfL were still associated with the deterioration of ROP.The area under the curve predicted by ADMA combined with NfL was higher than that predicted by each indicator alone(P<0.05).Conclusion The increase of serum ADMA and NfL levels in children with ROP is associated with the exacerbation and progression of the disease,and can be used as prognostic markers of ROP.

关 键 词：早产儿视网膜病变 严重程度 预后 不对称二甲基精氨酸 神经丝蛋白轻链 

分 类 号：R774.1[医药卫生—眼科]