HCMV感染对糖尿病视网膜病变患者血液流变学、氧化应激及视网膜病变的影响

Effects of HCMV infection on hemorheology,oxidative stress and retinopathy in patients with diabetic retinopathy

目的探讨人巨细胞病毒(HCMV)感染对糖尿病视网膜病变(DR)患者血液流变学、氧化应激及视网膜病变的影响。方法选取2019年4月-2021年4月在医院诊治的84例DR患者,采用聚合酶链反应(PCR)检测外周血中的HCMV-DNA,根据检测情况分为感染组(n=34)和未感染组(n=50)。检测两组患者神经纤维层(RNFL)厚度、黄斑厚度、视野平均缺损深度(MD)、血液流变学指标(高切全血黏度、中切全血黏度、低切全血黏度、血沉、血细胞比容)、血清氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、总抗氧化能力(TAOC)]水平,采用受试者工作特征(ROC)曲线评价血清MDA、SOD、TAOC及其联合检测诊断HCMV感染的效能。结果感染组RNFL厚度、黄斑厚度、MD值均低于未感染组(P<0.05);FPG高于未感染组,血液流变学指标高于未感染组(P<0.05);血清MDA高于未感染组,SOD、TAOC低于未感染组(P<0.05);血清MDA、SOD、TAOC及其联合检测诊断HCMV感染的ROC曲线下面积(AUC)分别为0.791、0.821、0.844及0.934(P<0.05)。结论HCMV感染可能通过诱导DR患者氧化应激反应,加重患者视网膜病变程度,增加患者血液黏度。

OBJECTIVE To explore the effects of human cytomegalovirus(HCMV)infection on hemorheology,oxidative stress and retinopathy in patients with diabetic retinopathy(DR).METHODS A total of 84 patients with DR treated in the hospital between Apr 2019 and Apr 2021were enrolled.HCMV-DNA in peripheral blood was detected by polymerase chain reaction(PCR).According to detection results,they were divided into the infection group(n=34)and non-infection group(n=50).The thickness of retinal nerve fiber layer(RNFL),macular thickness,mean defect of visual field(MD),levels of hemorheology indexes(high-shear whole blood viscosity,middle-shear whole blood viscosity,low-shear whole blood viscosity,erythrocyte sedimentation rate,hematocrit)and serum oxidative stress indexes,including superoxide dismutase(SOD),malondialdehyde(MDA)and total antioxidant capacity(TAOC)in both groups were detected.The diagnostic efficiency of serum MDA,SOD,TAOC individual and combined detection for HCMV infection was evaluated by receiver operating characteristic(ROC)curves.RESULTS RNFL thickness,macular thickness and MD in the infection group were significantly lower than those in the non-infection group(P<0.05),while FPG and hemorheology indexes were significantly higher than those in the non-infection group(P<0.05).Level of serum MDA was significantly higher than that in the non-infection group,while SOD and TAOC were significantly lower than those in the non-infection group(P<0.05).AUC values of serum MDA,SOD,TAOC indivudual and combined detection in the diagnosis of HCMV infection were 0.791,0.821,0.844 and 0.934,respectively(P<0.05).CONCLUSION HCMV infection may aggravate retinopathy and increase blood viscosity in DR patients by inducing oxidative stress response.