房水IL-17、IL-23、TNF-α水平在糖尿病性视网膜病变诊断中的价值

Values of Aqueous Humor IL-17,IL-23 and TNF-αLevels in Diagnosis of Patients with Diabetic Retinopathy

目的分析房水白细胞介素-17(IL-17)、白细胞介素-23(IL-23)、肿瘤坏死因子-α(TNF-α)水平在糖尿病性视网膜病变(DR)诊断中的应用价值。方法选取2019年2月—2020年10月本院收治的2型糖尿病患者82例(82眼)为研究对象,其中合并DR的患者50例为DR组,合并其他眼科疾病的患者32例为非DR组。将DR组按照是否为增殖期分为增殖期DR组22例和非增殖期DR组28例。取同期拟行白内障手术的年龄相关白内障50例(50眼)为对照组。检测各组房水IL-17、IL-23、TNF-α水平,分析IL-17、IL-23、TNF-α对DR诊断效能。结果DR组房水IL-17、IL-23、TNF-α水平明显高于非DR组与对照组,且非DR组明显高于对照组(P<0.01)。增殖期DR组房水IL-17、IL-23、TNF-α水平明显高于非增殖期DR组(P<0.01)。房水IL-17、IL-23、TNF-α及三者联合诊断DR的曲线下面积分别为0.885、0.902、0.782、0.965,三者联合诊断敏感度为91.7%,特异度为73.9%。结论DR患者房水IL-17、IL-23、TNF-α表达水平呈升高趋势,且病情越重,升高程度越大,三者联合对DR具有较高诊断效能。

Objective To analyze application values of aqueous humor interleukin 17(IL-17),interleukin 23(IL-23)and tumor necrosis factorα(TNF-α)levels in diagnosis of patients with diabetic retinopathy(DR).Methods A total of 82 patients(82 eyes)with type 2 diabetes mellitus(T2DM)treated between February 2019 and October 2020 were selected as research subjects,and 50 patients with DR were selected as DR group,while 32 patients with other ophthalmological diseases were selected as non-DR group.DR group was divided into proliferative DR subgroup(n=22)and non-proliferative DR subgroup(n=28)according to presence or absence of proliferation,and other 50 patients(50 eyes)with age-related cataract scheduled for cataract surgery at the same period were selected as control group.Levels of aqueous humor IL-17,IL-23 and TNF-αwere detected in each group,and the efficiencies of IL-17,IL-23 and TNF in diagnosis of DR were analyzed.Results Levels of aqueous humor IL-17,IL-23 and TNF-αin DR subgroup were significantly higher than those in non-DR subgroup and control group,and the levels in non-DR subgroup were significantly higher than those in control group(P<0.01).Levels of aqueous humor IL-17,IL-23 and TNF-αduring proliferation period were significantly higher than those during non-proliferation period in DR group(P<0.01).Areas under the curve of aqueous humor IL-17,IL-23,TNF-αand combination of the three indexes in diagnosis of DR were 0.885,0.902,0.782 and 0.965 respectively,and diagnostic sensitivity and specificity of combination of the three indexes were 91.7%and 73.9%respectively.Conclusion Levels of aqueous humor IL-17,IL-23 and TNF-αare increased in patients with DR.The severer the disease is,the greater the levels increase,and combination of the three indexes has good efficiency in diagnosis of DR.