IL-23、IL-17水平与糖尿病性黄斑水肿患者雷珠单抗应答性的相关性及预测意义  

Correlation between the level of interleukin-23 and interleukin-17 and the responsiveness of patients with diabetic macular edema to ranibizumab and relevant predictive significance

作　　者：秦玖刚[1] 王洪亮[2] 徐阳 QIN Jiugang;WANG Hongliang;XU Yang(Department of Clinical Medicine,Nanyang Medical College,Nanyang 473000,Henan Province,China;Ophthalmic Disease,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan Province,China;Outpatient Department of the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳医学高等专科学校临床医学系,河南省南阳市473000 [2]南阳医学高等专科学校第一附属医院眼科,河南省南阳市473000 [3]南阳医学高等专科学校第一附属医院门诊部,河南省南阳市473000

出　　处：《眼科新进展》2025年第5期387-392,共6页Recent Advances in Ophthalmology

基　　金：河南省自然科学基金项目(编号:232102310137)。

摘　　要：目的探究白细胞介素(IL)-23、IL-17水平与糖尿病性黄斑水肿(DME)患者雷珠单抗应答性的相关性及其预测意义。方法选取2021年9月至2023年6月南阳医学高等专科学校第一附属医院收治的249例249眼DME患者资料,根据雷珠单抗治疗应答分为敏感组(72例72眼)、非敏感组(177例177眼)。比较两组患者基线糖化血红蛋白(HbA1c)、最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)等资料,以及治疗前、治疗后1个月、治疗后3个月IL-23、IL-17水平。分析治疗后1个月、3个月IL-23、IL-17水平降低率与雷珠单抗应答性的相关性,分析治疗后1个月IL-23、IL-17水平降低率对雷珠单抗应答性的影响及预测价值。结果非敏感组患者基线HbA1c、BCVA均高于敏感组,基线CMT低于敏感组(均为P<0.05)。治疗后1个月、3个月,两组患者IL-23、IL-17水平均低于治疗前,非敏感组患者IL-23、IL-17水平均高于敏感组,治疗后1个月和3个月非敏感组IL-23、IL-17水平降低率均低于敏感组(均为P<0.05)。治疗后1个月、3个月,IL-23、IL-17水平降低率与治疗应答均呈正相关(均为P<0.05)。校正前Logistic回归分析显示,基线HbA1c、基线CMT、基线BCVA、治疗后1个月IL-23和IL-17水平降低率与DME患者雷珠单抗应答性均相关(均为P<0.05)。校正后Logistic回归分析显示,治疗后1个月,IL-23水平降低率和IL-17水平降低率仍与DME患者雷珠单抗应答性均相关(均为P<0.05)。治疗后1个月,IL-23水平降低率、IL-17水平降低率单独及联合预测DME患者雷珠单抗应答性的AUC分别为0.776、0.755、0.930,二者联合预测价值较高。结论DME患者对雷珠单抗的应答性与IL-23、IL-17水平有关,治疗后1个月血清IL-23、IL-17水平降低率联合预测DME患者雷珠单抗应答性的价值较高。Objective To investigate the correlation between the level of interleukin-23(IL-23)and IL-17 and the responsiveness of patients with diabetic macular edema(DME)to ranibizumab and relevant predictive significance.Methods A total of 249 DME patients who were admitted to the First Affiliated Hospital of Nanyang Medical College from September 2021 to June 2023 were included in this study.These patients were divided into the sensitive group(72 cases and 72 eyes)and the non-sensitive group(177 cases and 177 eyes)according to their responsiveness to ranibizumab treatment.The baseline glycated hemoglobin(HbA1c),best corrected visual acuity(BCVA),central macular thickness(CMT),as well as the IL-23 and IL-17 levels before treatment,1 month after treatment,and 3 months after treatment,were compared between the two groups.Besides,the correlation between the reduction rate of the IL-23 and IL-17 levels after 1 and 3 months of treatment and the responsiveness to ranibizumab was analyzed.Moreover,the impact of the reduction rate of the IL-23 and IL-17 levels after 1 month of treatment on the responsiveness to ranibizumab and its predictive value was assessed.Results The baseline HbA1c and BCVA in the non-sensitive group were higher than those in the sensitive group,while the baseline CMT in the non-sensitive group was lower than that in the sensitive group(all P<0.05).The IL-23 and IL-17 levels after 1 month and 3 months of treatment in both groups were lower than those before treatment.The IL-23 and IL-17 levels in the non-sensitive group were higher than those in the sensitive group after 1 month and 3 months of treatment.The reduction rate of IL-23 and IL-17 levels after 1 month and 3 months of treatment in the non-sensitive group was lower than that in the sensitive group(all P<0.05).The reduction rate of IL-23 and IL-17 levels after 1 month and 3 months of treatment was positively correlated with therapeutic responsiveness(both P<0.05).Before calibration,Logistic regression analysis showed that HbA1c,baseline CMT,baseline

关 键 词：白细胞介素-23 白细胞介素-17 糖尿病性黄斑水肿 雷珠单抗 治疗应答性 

分 类 号：R774[医药卫生—眼科]