血清及房水IGF-1、SOD水平在预测糖尿病性白内障患者术后发生囊膜混浊中的应用

Application of serum and aqueous humor IGF-1 and SOD levels in predicting postoperative capsule opacification in patients with diabetic cataract

目的探讨血清及房水胰岛素样生长因子1(IGF-1)、超氧化物岐化酶(SOD)水平在预测糖尿病性白内障(DC)患者术后发生囊膜混浊(PCO)中的应用价值。方法选择120例DC患者为DC组,同期选择接受手术治疗的单纯白内障患者77例为对照组。所有DC患者术后至少随访6个月,根据是否并发PCO将DC患者分为PCO组(21例)和非PCO组(99例)。术前用酶联免疫吸附试验检测血清及房水中IGF-1、SOD,收集DC患者术后发生PCO的相关资料。用多因素Logistic回归分析血清及房水IGF-1、SOD对DC患者术后发生PCO的影响;绘制受试者工作特征(ROC)曲线,用曲线下面积比较血清及房水IGF-1、SOD预测DC患者术后发生PCO的价值。结果DC组血清及房水IGF-1水平高于对照组(P均<0.05),SOD水平低于对照组(P均<0.05)。PCO组年龄、C反应蛋白水平、亲水型人工晶体比例高于非PCO组(P均<0.05)。亲水型人工晶体、房水IGF-1水平高是DC患者术后发生PCO的危险因素(P均<0.05),房水SOD水平高是保护因素(P<0.05)。血清及房水IGF-1、SOD预测DC患者术后发生PCO的曲线下面积分别为0.749、0.720、0.859、0.884,房水IGF-1、SOD预测DC患者术后发生PCO的曲线下面积大于血清IGF-1、SOD预测的曲线下面积(P均<0.05),房水IGF-1、SOD联合预测DC患者术后发生PCO的曲线下面积为0.967,大于房水IGF-1、SOD单独预测的曲线下面积(P均<0.05)。结论房水IGF-1水平升高、SOD水平降低与DC患者术后发生PCO有关,血清及房水中IGF-1、SOD可用于预测DC患者术后PCO的发生,且房水中IGF-1、SOD联合预测的价值较高。

Objective To investigate the application value of serum and aqueous humor insulin-like growth factor 1(IGF-1)and superoxide dismutase(SOD)levels in predicting postoperative posterior capsular opacification(PCO)in pa⁃tients with diabetic cataract(DC).Methods Totally 120 patients with DC were selected as the DC group,and 77 pa⁃tients with simple cataract who underwent surgical treatment were selected as the control group.All DC patients were fol⁃lowed up for at least 6 months after surgery.According to the presence or absence of PCO,DC patients were divided into PCO group(21 cases)and non-PCO group(99 cases).The levels of IGF-1 and SOD in serum and aqueous humor were de⁃tected by enzyme-linked immunosorbent assay before operation,and the related data of PCO in DC patients after operation were collected.Multivariate Logistic regression analysis was used to analyze the effects of IGF-1 and SOD in serum and aqueous humor on PCO in patients with DC after operation;the receiver operating characteristic(ROC)curve was drawn,and the area under the curve was used to compare the value of serum and aqueous humor IGF-1 and SOD in predicting PCO in patients with DC.Results The levels of IGF-1 in serum and aqueous humor in the DC group were higher than those in the control group,and the levels of SOD were lower than those in the control group(all P<0.05).The age,C-reactive pro⁃tein level and the proportion of hydrophilic intraocular lens in the PCO group were higher than those in the non-PCO group(all P<0.05).Hydrophilic intraocular lens and high level of IGF-1 in aqueous humor were risk factors for PCO in patients with DC(all P<0.05),and high level of SOD in aqueous humor was a protective factor(all P<0.05).The area under the curve of serum and aqueous humor IGF-1 and SOD in predicting postoperative PCO in DC patients was 0.749,0.720,0.859,and 0.884,respectively.The area under the curve of aqueous humor IGF-1 and SOD in predicting postoperative PCO in DC patients was greater than that of serum IGF-1 and SOD(all P<0.05).The area under the curve of aqueous hu⁃mor IGF-1 and SOD in predicting postoperative PCO in DC patients was 0.967,which was greater than that of aqueous hu⁃mor IGF-1 and SOD alone(both P<0.05).Conclusions The increase of IGF-1 level and the decrease of SOD level in aqueous humor are related to the occurrence of postoperative PCO in DC patients.IGF-1 and SOD in serum and aqueous humor can be used to predict the occurrence of postoperative PCO in DC patients,and the predictive value of IGF-1 com⁃bined with SOD in aqueous humor is higher.