单纯型糖尿病视网膜病变患者细胞因子动态变化与病情的相关性

Correlation between dynamic changes of cytokines and condition of disease in patients with simple diabetic retinopathy

目的探讨单纯型糖尿病视网膜病变(DR)患者细胞因子动态变化与病情的相关性。方法前瞻性选取2020年10月—2021年3月本院收治的222例单纯型DR患者为研究对象,随访观察1年并按照病情转归情况分为增生型糖尿病视网膜病变(PDR)组和非PDR组。比较2组患者一般资料、细胞因子水平,采用多因素Logistic回归模型分析影响单纯型DR患者病情的相关因素。结果截至2022年4月1日,5例失访,最终纳入217例,随访率97.75%,其中61例(28.11%)出现PDR者设为PDR组,156例(71.89%)未出现PDR者设为非PDR组。2组患者血清中血管内皮生长因子(VEGF)、白细胞介素-18(IL-18)、白细胞介素-1β(IL-1β)变化率比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,VEGF变化率(OR=1.054,95%CI:1.047~1.061)、IL-18变化率(OR=1.163,95%CI:1.150~1.175)、IL-1β变化率(OR=1.132,95%CI:1.120~1.144)为单纯型DR病情进展的危险因素(P<0.001)。结论VEGF、IL-1β、IL-18动态变化与单纯型DR患者病情变化有关。

Objective To explore the correlation between dynamic changes of cytokines and con⁃dition of disease in patients with simple diabetic retinopathy(DR).Methods A total of 222 patients with simple DR in authors′hospital from October 2020 to March 2021 were prospectively selected as the research objects,and they were divided into proliferative diabetic retinopathy(PDR)group and non⁃PDR group according to the disease outcome after a year of follow up.General materials and cyto⁃kine levels were compared between the two groups,and the multivariate Logistic regression model was used to analyze the related factors affecting the condition of disease in patients with simple DR.Results Up to April,2022,5 cases were lost during follow⁃up,and 217 cases were finally included,with a follow⁃up rate of 97.75%;among the 217 cases,61 cases(28.11%)with PDR were selected as PDR group,and 156 cases(71.89%)without PDR were selected as non⁃PDR group.There were significant differences in the change rates of serum vascular endothelial growth factor(VEGF),inter⁃leukin⁃18(IL⁃18)and interleukin⁃1β(IL⁃1β)between the two groups(P<0.05).Multivariate Logistic regression analysis showed that change rate of after 1 year follow⁃up and according to the out⁃come of the disease vascular endothelial growth factor VEGF(OR=1.054,95%CI,1.047 to 1.061),change rate of IL⁃18(OR=1.163,95%CI,1.150 to 1.175)and change rate of IL⁃1β(OR=1.132,95%CI,1.120 to 1.144)were the risk factors for the progression of simple DR(P<0.001).Conclusion The dynamic changes of VEGF,IL⁃1βand IL⁃18 are related to the change of disease in patients with simple DR.