血清AQP4、DCN、Apelin水平对早产儿视网膜病变诊断及病理分期的评估价值

Evaluation value of serum levels of AQP4,DCN,Apelin in the diagnosis and pathological staging ofretinopathy of prematurity

目的探讨血清水通道蛋白4(AQP4)、核心蛋白聚糖(DCN)、爱帕琳肽(Apelin)水平对早产儿视网膜病变(ROP)诊断及病理分期的评估价值。方法选择2021年10月至2022年10月在该院接受治疗的64例ROP患儿(共128眼)作为ROP组,同时选择相同出生胎龄段无ROP的64例早产儿(共128眼)作为正常组。采用酶联免疫吸附试验(ELISA)测定血清AQP4、DCN、Apelin水平;采用多因素Logistic回归分析影响ROP发生的因素。采用受试者工作特征(ROC)曲线分析血清AQP4、DCN、Apelin对ROP发生及病理分期的诊断价值。结果与正常组相比,ROP组的出生体质量显著降低(P>0.05)。ROP组血清AQP4、DCN、Apelin水平均高于正常组(P<0.05)。不同病理分期ROP患儿血清AQP4、DCN、Apelin水平差异有统计学意义(P<0.05)。根据多因素Logistic回归分析得知,AQP4、DCN、Apelin是影响ROP发生的危险因素(P<0.05),出生体质量是影响ROP发生的保护因素(P<0.05)。血清AQP4、DCN、Apelin三者联合诊断ROP发生的曲线下面积(AUC)最大,优于血清AQP4、DCN、Apelin各自单独诊断(Z_(三者联合-AQP4)=3.018、P=0.003,Z_(三者联合-DCN)=2.306、P=0.021,Z_(三者联合-Apelin)=3.301、P=0.001)。血清AQP4、DCN、Apelin三者联合诊断ROP病理分期的AUC最大,优于血清AQP4、DCN、Apelin各自单独诊断(Z_(三者联合-AQP4)=2.735、P=0.006,Z_(三者联合-DCN)=2.228、P=0.026,Z_(三者联合-Apelin)=2.594、P=0.001)。结论ROP患儿血清AQP4、DCN、Apelin水平显著升高,三者联合可更好地诊断ROP发生及评估其病理分期。

Objective To explore the evaluation value of serum levels of aquaporin 4(AQP4),decorin(DCN),and Apelin in the diagnosis and pathological staging of retinopathy of prematurity(ROP).Methods A total of 64 ROP children(128 eyes)who received treatment in the hospital from October 2021 to October 2022 were collected as the ROP group,while 64 premature infants of the same birth age without ROP((128 eyes)were regarded as the normal group.Enzyme linked immunosorbent assay(ELISA)was applied to measure the levels of serum AQP4,DCN,and Apelin.Multivariate Logistic regression was applied to analyze the factors that affected the occurrence of ROP.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum AQP4,DCN,and Apelin in the occurrence and pathological staging of ROP.Results Compared with the normal group,the birth weight in the ROP group was obviously reduced(P>0.05).The serum levels of AQP4,DCN,and Apelin in the ROP group were obviously higher than those in the normal group(P<0.05).The serum levels of AQP4,DCN,and Apelin in children with ROP at different pathological stages showed statistically significant differences(P<0.05).According to multivariate Logistic regression analysis,AQP4,DCN,and Apelin were risk factors affecting the occurrence of ROP(P<0.05),while birth weight was a protective factor affecting the occurrence of ROP(P<0.05).The combination of serum AQP4,DCN,and Apelin had the largest area under the curve(AUC)for the diagnosis of ROP,which was superior to the individual diagnosis of serum AQP4,DCN,and Apelin(Z_(combination-AQP4)=3.018,P=0.003,Z_(combination-DCN)=2.306,P=0.021,Z_(combination-Apelin)=3.301,P=0.001).The combination of serum AQP4,DCN,and Apelin had the largest AUC for the diagnosis of pathological staging of ROP,which was superior to the individual diagnosis of serum AQP4,DCN,and Apelin(Z_(combination-AQP4)=2.735,P=0.006,Z_(combination-DCN)=2.228,P=0.026,Z_(combination-Apelin)=2.594,P=0.001).Conclusion The serum levels of AQP4,DCN,and Apelin in children with ROP are obviously increased,and the combination of the three could better diagnose the occurrence of ROP and evaluate the pathological staging.