血管内皮生长因子、血管细胞间黏附分子与增殖型糖尿病视网膜病变的相关性及联合诊断价值研究

Study on the correlation between vascular endothelial growth factor,vascular intercellular adhesion molecule and proliferative diabetic retinopathy and their combined diagnostic value

目的:探讨血管内皮生长因子(VEGF)、血管细胞间黏附分子(ICAM-1)与增殖型糖尿病视网膜病变的相关性及联合诊断价值。方法:回顾性研究2017年4月至2020年4月于本院确诊糖尿病视网膜病变153例。72例为增殖型糖尿病视网膜病变患者,将其纳入观察组;81例为非增殖型糖尿病视网膜病变患者,纳入对照组。采用流式细胞仪对血管内皮细胞(CEC)进行分型测定,采用酶联免疫吸附法测定VEGF、ICAM-1,并比较组间的差异性与相关性,应用ROC曲线测定其联合诊断效能。结果:观察组CEC含量显著高于对照组(P<0.05);观察组循环祖细胞(CPC)含量显著低于对照组(P<0.05);观察组VEGF、ICAM-1水平显著高于对照组(P<0.05)。相关性分析可知VEGF与ICAM-1呈显著的正相关关系(r=0.732,P=0.011),VEGF与CEC呈显著的正相关关系(r=0.684,P=0.023),VEGF与CPC呈显著的负相关关系(r=-0.622,P=0.041)。VEGF的曲线下面积(AUC)为0.844,特异度为85.32%,灵敏度为82.16%;ICAM-1的AUC为0.821,特异度为83.74%,灵敏度为80.21%;联合诊断的AUC为0.914,特异度为88.92%,灵敏度为92.25%。结论:VEGF、ICAM-1与增殖型糖尿病视网膜病变呈显著的同向变化关系,即VEGF、ICAM-1随着病变进展而升高,并且有较好的联合诊断效能。

Objective:To investigate the correlation between vascular endothelial growth factor(VEGF),vascular intercellular adhesion molecule-1(ICAM-1)and proliferative diabetic retinopathy and their combined diagnostic value.Methods:153 cases of diabetic retinopathy diagnosed in our hospital from April 2017 to April 2020 were retrospectively studied.72 patients with proliferative diabetic retinopathy were included in the observation group;81 patients with non proliferative diabetic retinopathy were included in the control group.Flow cytometry was used to determine the type of vascular endothelial cells,and enzyme-linked immunosorbent assay was used to detect VEGF and ICAM-1.The difference and correlation between the two groups were compared,and ROC curve was used to determine the combined diagnostic efficiency.Results:The content of circulating endothelial cells(CEC)in the observation group was significantly higher than that in the control group(P<0.05);the content of circulating progenitor cells(CPC)in the observation group was significantly lower than that in the control group(P<0.05);the levels of VEGF and ICAM-1 in the observation group were significantly higher than those in the control group(P<0.05).There was a significantly positive correlation between VEGF and ICAM-1(r=0.732,P=0.011),there was a significantly positive correlation between VEGF and CEC(r=0.684,P=0.023,there was a significantly negative correlation between VEGF and CPC(r=-0.622,P=0.041).The area under the curve(AUC)of VEGF was 0.844,specificity was 85.32%,sensitivity was 82.16%;AUC of ICAM-1 was 0.821,specificity was83.74%,sensitivity was 80.21%;AUC of joint diagnosis was 0.914,specificity was 88.92%,sensitivity was92.25%.Conclusion:VEGF and ICAM-1 have a significant co-directional change relantionship with proliferative diabetic retinopathy,that is,VEGF and ICAM-1 increase with the disease,and have good joint diagnostic efficacy.