【摘要】 目的:探讨血管内皮生长因子(VEGF)、血管细胞间黏附分子(ICAM-1)与增殖型糖尿病视网膜病变的相关性及联合诊断价值。方法:回顾性研究2017年4月至2020年4月于本院确诊糖尿病视网膜病变153例。72例为增殖型糖尿病视网膜病变患者,将其纳入观察组; 81例为非增殖型糖尿病视网膜病变患者,纳入对照组。采用流式细胞仪对血管内皮细胞(CEC)进行分型测定,采用酶联免疫吸附法测定VEGF、ICAM-1,并比较组间的差异性与相关性,应用ROC曲线测定其联合诊断效能。结果:观察组CEC含量显著高于对照组(P <0.05);观察组循环祖细胞(CPC)含量显著低于对照组(P <0.05);观察组VEGF、ICAM-1水平显著高于对照组(P <0.05)。相关性分析可知VEGF与ICAM-1呈显著的正相关关系(r=0.732,P=0.011),VEGF与CEC呈显著的正相关关系(r=0.684,P=0.023),VEGF与CPC呈显著的负相关关系(r=-0.622,P=0.041)。VEGF的曲线下面积(AUC)为0.844,特异度为85.32%,灵敏度为82.16%; ICAM-1的AUC为0.821,特异度为83.74%,灵敏度为80.21%;联合诊断的AUC为0.914,特异度为88.92%,灵敏度为92.25%。结论:VEGF、ICAM-1与增殖型糖尿病视网膜病变呈显著的同向变化关系,即VEGF、ICAM-1随着病变进展而升高,并且有较好的联合诊断效能。更多还原

【Abstract】 Objective: To investigate the correlation between vascular endothelial growth factor( VEGF),vascular intercellular adhesion molecule-1( ICAM-1) and proliferative diabetic retinopathy and their combined diagnostic value. Methods: 153 cases of diabetic retinopathy diagnosed in our hospital from April 2017 to April 2020 were retrospectively studied. 72 patients with proliferative diabetic retinopathy were included in the observation group;81 patients with non proliferative diabetic retinopathy were included in the control group. Flow cytometry was used to determine the type of vascular endothelial cells,and enzyme-linked immunosorbent assay was used to detect VEGF and ICAM-1. The difference and correlation between the two groups were compared,and ROC curve was used to determine the combined diagnostic efficiency. Results: The content of circulating endothelial cells( CEC)in the observation group was significantly higher than that in the control group( P < 0. 05); the content of circulating progenitor cells( CPC) in the observation group was significantly lower than that in the control group( P < 0. 05); the levels of VEGF and ICAM-1 in the observation group were significantly higher than those in the control group( P <0. 05). There was a significantly positive correlation between VEGF and ICAM-1( r = 0. 732,P = 0. 011),there was a significantly positive correlation between VEGF and CEC( r = 0. 684,P = 0. 023,there was a significantly negative correlation between VEGF and CPC( r =-0. 622,P = 0. 041). The area under the curve( AUC) of VEGF was 0. 844,specificity was 85. 32%,sensitivity was 82. 16%; AUC of ICAM-1 was 0. 821,specificity was83. 74%,sensitivity was 80. 21%; AUC of joint diagnosis was 0. 914,specificity was 88. 92%,sensitivity was92. 25%. Conclusion: VEGF and ICAM-1 have a significant co-directional change relantionship with proliferative diabetic retinopathy,that is,VEGF and ICAM-1 increase with the disease,and have good joint diagnostic efficacy.更多还原