2型糖尿病白内障患者房水SDF-1、ANGPTL4、GRP78与术后黄斑水肿的关系及其预测效能分析

Relationship between SDF-1, ANGPTL4, GRP78 in Aqueous Humor and Postoperative MacularEdema in Patients with Type 2 Diabetic Cataract and Their Predictive Efficacy Analysis

目的:探讨2型糖尿病白内障患者房水基质细胞衍生因子-1(SDF-1)、血管生成素样4(ANGPTL4)、葡萄糖调节蛋白78(GRP78)与术后黄斑水肿(ME)的关系及其预测效能分析。方法:选择2020年1月至2023年3月我院收治的195例2型糖尿病白内障患者(195眼),所有患者行白内障超声乳化联合折叠式人工晶体植入术,根据术后是否发生ME将患者分为ME组(45例)和无ME组(150例)。术前检测房水中SDF-1、ANGPTL4、GRP78水平,收集临床资料。多因素Logistic回归分析2型糖尿病白内障患者术后发生ME的影响因素,采用受试者工作特征(ROC)曲线分析术前房水SDF-1、ANGPTL4、GRP78水平预测2型糖尿病白内障患者术后发生ME的预测价值。结果:ME组术前房水SDF-1、ANGPTL4、GRP78水平高于无ME组(P<0.05)。高糖化血红蛋白、高SDF-1、高ANGPTL4、高GRP78是2型糖尿病白内障患者术后发生ME危险因素(P<0.05)。术前房水SDF-1、ANGPTL4、GRP78水平预测2型糖尿病白内障患者术后发生ME的曲线下面积(AUC)分别为0.809、0.801、0.760,联合SDF-1、ANGPTL4、GRP78预测的曲线下面积为0.896,高于单独检测(P<0.05)。结论:2型糖尿病白内障患者术前房水SDF-1、ANGPTL4、GRP78水平增高与术后ME的发生有关,联合SDF-1、ANGPTL4、GRP78预测ME发生具有较高应用价值。

Objective:To investigate the relationship between stromal cell-derived factor-1(SDF-1),angiopoietin-like 4(ANGPTL4),glucose-regulated protein 78(GRP78)and postoperative macular edema(ME)in patients with type 2 diabetic cataract and their predictive efficacy analysis.Methods:195 patients(195 eyes)with type 2 diabetic cataract who were admitted to our hospital from January 2020 to March 2023 were selected,all patients underwent phacoemulsification combined with foldable intraocular lens implantation,patients were divided into ME group(45 cases)and non-ME group(150 cases)according to whether ME occurred after operation.The levels of SDF-1,ANGPTL4 and GRP78 in aqueous humor were detected before operation,and clinical data were collected.The influencing factors of postoperative ME in patients with type 2 diabetic cataract were analyzed by multivariate Logistic regression analysis,the predictive value of preoperative aqueous humor SDF-1,ANGPTL4 and GRP78 levels in predicting postoperative ME in patients with type 2 diabetic cataract were analyzed by receiver operating characteristic(ROC)curve.Results:The levels of SDF-1,ANGPTL4 and GRP78 in aqueous humor before operation in ME group were higher than those in non-ME group(P<0.05).High glycated hemoglobin,high SDF-1,high ANGPTL4,and high GRP78 were risk factors for postoperative ME in patients with type 2 diabetic cataract(P<0.05).The area under the curve(AUC)of preoperative SDF-1,ANGPTL4 and GRP78 levels in aqueous humor to predict postoperative ME in patients with type 2 diabetic cataract was 0.809,0.801 and 0.760 respectively,the area under the curve predicted by combined SDF-1,ANGPTL4 and GRP78 was 0.896,which was higher than that of single detection(P<0.05).Conclusion:The increase levels of SDF-1,ANGPTL4 and GRP78 in aqueous humor of patients with type 2 diabetic cataract before operation are relate to the occurrence of postoperative ME,the combination of SDF-1,ANGPTL4 and GRP78 has high application value in predicting the occurrence of ME.