视网膜中央静脉阻塞继发黄斑水肿患者血清AQP4、 SHBG mRNA表达及预测价值分析

An Analysis of Serum AQP4 and SHBG mRNA Expressions and Their Predictive Values in Patients with Macular Edema Secondary to Central Retinal Vein Occlusion

目的检测视网膜中央静脉阻塞(CRVO)继发黄斑水肿(ME)患者血清水通道蛋白4(AQP4)、性激素结合球蛋白(SHBG)信使RNA(mRNA)表达水平,并分析二者对CRVO-ME的预测价值。方法选取2020年6月至2023年3月在徐州医科大学附属淮安医院眼科就诊的经初次确诊为CRVO-ME的94例患者作为CRVO-ME组,另选取同期确诊为单纯的CRVO无ME患者93例作为CRVO组,正常体检健康人群90例作为对照组。收集所有受试者临床资料,检测实验室指标和血清AQP4、SHBG mRNA表达水平。分析CRVO-ME患者血清AQP4 mRNA和SHBG mRNA表达水平的相关性,影响CRVO患者继发ME的危险因素,血清AQP4、SHBG mRNA表达水平对CRVO患者继发ME的预测价值。结果对照组、CRVO组、CRVO-ME组舒张压、收缩压、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(Hcy)、空腹血糖(FBG)、AQP4 mRNA表达水平依次升高,高密度脂蛋白胆固醇(HDL-C)、SHBG mRNA表达水平依次降低(P<0.05);CRVO-ME患者血清AQP4 mRNA和SHBG mRNA表达水平呈负相关关系(P<0.05);FBG高水平、AQP4 mRNA高表达水平、SHBG mRNA低表达水平是CRVO患者继发ME的危险因素(P<0.05);血清AQP4、SHBG mRNA、两者联合预测CRVO患者继发ME的曲线下面积(AUC)分别为0.646、0.781、0.802;与血清AQP4、SHBG mRNA各自单独预测的AUC比较,两者联合预测的AUC较高(P<0.05)。结论CRVO-ME患者血清中AQP4 mRNA表达水平异常升高,SHBG mRNA表达水平异常降低,二者对CRVO-ME具有一定的预测价值。

Objective To detect serum aquaporin 4(AQP4)and sex hormone binding globulin(SHBG)messenger RNA(mRNA)expression levels in patients with central retinal vein occlusion(CRVO)secondary macular edema(ME),and to analyze their predictive values for CRVO-ME.Methods A total of 94 patients with CRVO-ME initially diagnosed in the Department of Ophthalmology of Huai’an Hospital affiliated to Xuzhou Medical University from June,2020 to March,2023 were selected as the CRVO-ME group,while 93 patients diagnosed with CRVO without ME during the same period were selected as the CRVO group,and 90 healthy people with normal physical examination were selected as the control group.Clinical data of all subjects were collected,and laboratory indicators and serum AQP4 and SHBG mRNA expression levels were detected.We analyzed the correlation between expression levels of serum AQP4 mRNA and SHBG mRNA in patients with CRVO-ME,identified the risk factors of secondary ME in patients with CRVO,and evaluated the predictive value of expression levels of serum AQP4 and SHBG mRNA on secondary ME in patients with CRVO.Results Expression levels of diastolic blood pressure,systolic blood pressure,total cholesterol(TC),triglyceride(TG),low density lipoprotein-cholesterol(LDL-C),homocysteine(Hcy),fasting blood glucose(FBG)and AQP4 mRNA in the control group,CRVO group and CRVO-ME group were increased in turn,while expression levels of high-density lipoprotein-cholesterol(HDL-C)and SHBG mRNA were decreased in turn(P<0.05);Expression level of serum AQP4 mRNA and SHBG mRNA in CRVO-ME patients was negatively correlated(P<0.05);The high level of FBG,high expression levels of AQP4 mRNA and low expression levels of SHBG mRNA were risk factors for secondary ME in CRVO patients(P<0.05);The area under the curve(AUC)of serum AQP4,SHBG mRNA and their combination in predicting secondary ME in patients with CRVO were 0.646,0.781 and 0.802,respectively;Compared with the AUCs predicted by serum AQP4 and SHBG mRNA individually,the AUC predicted jointly by the two markers was higher(P<0.05).Conclusion The serum AQP4 mRNA expression level of CRVO-ME patients is abnormally increased,while the serum SHBG mRNA expression level is abnormally decreased,and both of them have certain predictive value for CRVO-ME.