血管内皮生长因子与糖尿病黄斑水肿严重程度的关系

Relationship between Vascular Endothelial Growth Factor and the Severity of Diabetic Macular Edema

目的:探讨血管内皮生长因子(vascular endothelial growth factor,VEGF)与糖尿病黄斑水肿(diabetic macular edema,DME)严重程度关系。方法:选取2020年10月-2021年12月就诊于深圳市宝安区福永人民医院内分泌科、眼科的100例DME患者。将所有患者进行分级,并检测血清VEGF水平。比较不同DME严重程度患者一般资料(年龄、性别),VEGF水平,并分析VEGF与DME严重程度的相关性,并分析VEGF诊断DME严重程度的价值,检验VEGF程度分级和DME程度分级的一致性。结果:100例患者中轻度39例,中-重度61例。不同DME严重程度患者性别、年龄比较差异均无统计学意义(P>0.05)。中-重度DME患者血清中VEGF显著高于轻度DME患者(P<0.05)。Spearman相关性分析显示,VEGF与DME程度呈显著正相关关系(P<0.05)。ROC曲线分析结果显示,VEGF诊断DME程度的AUC为0.878(SE=0.034,P=0.000,95%CI:0.811,0.945),说明VEGF诊断DME严重程度价值较好。约登指数=敏感度-(1-特异度),选择约登指数最大值为诊断截点,当敏感度为83.6%,特异度为82.1%时,约登指数最大为0.657,诊断效能较好,对应的诊断截点为411.0 pg/ml。经Kappa一致性检验,VEGF与DME眼底检查分级诊断具有较好的一致性(P<0.05)。结论:VEGF水平与DME严重程度存在显著相关性,且可作为DME分级诊断的生物学指标。

Objective:To investigate the relationship between vascular endothelial growth factor(VEGF)and the severity of diabetic macular edema(DME).Method:A total of 100 patients with DME were selected from the department of endocrinology and ophthalmology in Fuyong People’s Hospital,Bao’an District,Shenzhen City from October 2020 to December 2021.All patients were graded and serum VEGF levels were detected.The general information(age,gender)and VEGF levels of patients with different severity degrees of DME were compared,and the correlation between VEGF and DME severity degree was analyzed,as well as the diagnostic value of VEGF in DME severity degree was analyzed,and the consistency between VEGF grade and DME grade was tested.Result:Among the 100 patients,39 patients were mild and 61 patients were moderate to severe.There were no significant differences in gender and age among patients with different degrees of DME(P>0.05).Serum VEGF of patients with moderate to severe DME was significantly higher than that of patients with mild DME(P<0.05).Spearman correlation analysis showed that there was a significant positive correlation between VEGF and DME degree(P<0.05).ROC curve analysis showed that the AUC of VEGF in diagnosing DME degree was 0.878(SE=0.034,P=0.000,95%CI:0.811,0.945),indicating a good value of VEGF in diagnosing DME severity.Youden index=sensitivity-(1-specificity),and the maximum value of the Youden index was selected as the diagnostic cut-off point.When the sensitivity was 83.6%and the specificity was 82.1%,the maximum value of the Youden index was 0.657,indicating good diagnostic efficiency and the corresponding diagnostic cut-off point was 411.0 pg/ml.According to Kappa consistency test,there was a good consistency between VEGF and DME fundus examination grading diagnosis(P<0.05).Conclusion:There is a significant correlation between VEGF level and DME severity,and it can be used as a biological index for DME grading diagnosis.