血浆炎症标志物联合OCT在年龄相关性黄斑变性检测中的性能研究

Study on the Diagnostic Performance of Plasma Inflammatory Markers Combined with OCT in Age-related Macular Degeneration

目的:探讨血浆炎症标志物与光学相干断层扫描(OCT)联合使用在年龄相关性黄斑变性(AMD)检测中的性能,以期提高诊断的准确性和及时性。方法:研究纳入苏州理想眼科医院2022年1月—2024年1月52例(52眼)AMD患者作为观察组,另选取同期进行检查的健康者52例(52眼)作为对照组。两组均接受OCT扫描和血浆炎症标志物的测定,对比两组炎症标志物及OCT结果,分析血浆标志物与OCT单独使用及联合使用诊断效能。结果:观察组白细胞(WBC)、单核细胞(MON)、嗜中性粒细胞(NEU)计数、淋巴细胞百分比、中性粒细胞计数/淋巴细胞计数比值(NLR)均高于对照组,差异均有统计学意义(P<0.05)。炎症标志物诊断结果真阳性49例,假阴性3例,真阴性31例,假阳性21例;OCT扫描结果,真阳性44例,真阴性46例,假阳性6例,假阴性8例;联用诊断结果真阳性49例,真阴性47例,假阳性5例,假阴性3例,三种方法Kappa值分别为0.869、0.769、0.884。炎症标志物诊断敏感度为94.23%,特异度为59.62%;OCT扫描诊断敏感度为84.62%,特异度为88.46%;联用诊断敏感度为94.23%,特异度为90.38%。结论:血浆炎症标志物联合OCT在年龄相关性黄斑变性的检测中显示出较高的诊断性能,可以有效提高AMD的早期诊断准确性。

Objective:To investigate the diagnostic performance of plasma inflammatory markers combined with optical coherence tomography(OCT)in age-related macular degeneration(AMD),to improve diagnostic accuracy and timeliness.Method:A total of 52 AMD patients(52 eyes)from Soochow Lixiang Eye Hospital between January 2022 and January 2024 were selected as the observation group,and 52 healthy individuals(52 eyes)examined during the same period were selected as the control group.Both groups underwent OCT scanning and plasma inflammatory marker measurement.The results of inflammatory markers and OCT were compared between two groups,and the diagnostic efficiency of using plasma markers alone,OCT alone,and their combination were analyzed.Result:In the observation group,white blood cell(WBC)count,monocyte(MON)count,neutrophil(NEU)count,lymphocyte percentage,and neutrophil-to-lymphocyte ratio(NLR)were higher than those in the control group(P<0.05).The diagnostic results for inflammatory markers showed 49 true positives,3 false negatives,31 true negatives,and 21 false positives.For OCT,there were 44 true positives,46 true negatives,6 false positives,and 8 false negatives.The combined diagnostic results showed 49 true positives,47 true negatives,5 false positives,and 3 false negatives.The Kappa values for the three methods were 0.869,0.769 and 0.884,respectively.The sensitivity and specificity were as follows:inflammatory markers had a sensitivity of 94.23%and specificity of 59.62%;OCT had a sensitivity of 84.62%and specificity of 88.46%;the combined method had a sensitivity of 94.23%and specificity of 90.38%.Conclusion:The combination of plasma inflammatory markers and OCT demonstrates has high diagnostic performance in detecting age-related macular degeneration,effectively improving the accuracy of early diagnosis of AMD.