【摘要】 目的 探讨不同分期糖尿病性视网膜病变(DR)患者中趋化因子的表达情况及临床意义。方法 选取2019年4月～2021年12月我院收治的DR患者120例，按照DR病情程度将其分为DRⅠ期组(11例)、DRⅡ期组(21例)、DRⅢ期组(28例)、DRⅣ期组(35例)及DRⅤ组(25例)。DRⅠ～Ⅲ期为非增生型DR,DRⅣ～Ⅴ期为增生型DR。收集各组患者基线资料、相关实验室检查指标及趋化因子[趋化因子样受体1(CMKLR-1)、趋化素(Chemerin)]水平并分组进行比较。采用logistic回归分析评估DR患者病情的影响因素；采用受试者工作特征(ROC)曲线分析趋化因子CMKLR-1、Chemerin对DR患者病情的评估价值。结果 DRⅣ期组及Ⅴ期组患者收缩压均高于DRⅠ期组、Ⅱ期组及Ⅲ期组；DRⅣ期组及Ⅴ期组患者肿瘤坏死因子(TNF)-α、IL-1β、IL-6、核转录因子(NF)-κB、CMKLR-1、Chemerin水平均高于DRⅠ期组、Ⅱ期组及Ⅲ期组，DRⅡ期组及Ⅲ期组患者Chemerin水平均高于DRⅠ期组(P<0.05)。Logistic回归分析结果显示，收缩压高、TNF-α、IL-1β、IL-6、NF-κB、CMKLR-1、Chemerin水平高均是影响DR患者病情的危险因素(P<0.05)。ROC曲线分析结果显示，CMKLR-1、Chemerin单独及二者联合检测评估增生型DR的AUC>0.70,具有一定的评估价值。结论 趋化因子CMKLR-1、Chemerin在不同分期DR患者中的表达存在差异，且能为增生型DR的评估提供参考。更多还原

【Abstract】 Objective To investigate the expression and clinical significance of chemokines in patients with different stages of diabetic retinopathy(DR).Methods A total of 120 patients with DR treated in our hospital from April 2019 to December 2021 were selected and divided into DR Ⅰ group(11 cases),DR Ⅱ group(21 cases),DR Ⅲ group(28 cases),DR Ⅳ group(35 cases) and DR Ⅴ group(25 cases) according to the degree of retinopathy.DR Stage Ⅰ-Ⅲ was non-proliferative DR,and DR Stage Ⅳ-Ⅴ was proliferative DR.Baseline data, relevant laboratory examination indicators and chemokine levels[chemokine-like receptor 1(CMKLR-1),Chemerin] of patients in each group were collected and compared in groups.Logistic regression analysis was used to evaluate the factors affecting the severity of DR disease.The value of chemokines CMKLR-1 and Chemerin in evaluating the severity of DR disease was analyzed by receiver operating characteristic(ROC) curve.Results Systolic blood pressure of patients in DR Ⅳ and Ⅴ groups was higher than that in DR Ⅰ group, Ⅱ group and Ⅲ group; levels of tumor necrosis factor(TNF)-α,IL-1β,IL-6,nuclear factor-κb(NF-κB),CMKLR-1 and Chemerin in DR Ⅳ and Ⅴ groups were higher than those in DR Ⅰ group, Ⅱ group, Ⅲ group; level of Chemerin in DR Ⅱ and Ⅲ groups were higher than that in DR Ⅰ group(P<0.05).Results of logistic regression analysis showed that high systolic blood pressure, TNF-α,IL-1β,IL-6,NF-κB,CMKLR-1 and Chemerin were risk factors for DR(P<0.05).ROC curve analysis results showed that the AUC of CMKLR-1,Chemerin alone and their combination in the evaluation of proliferative DR was>0.70,which had a certain evaluation value.Conclusion There are differences in the expression of chemokine CMKLR-1 and Chemerin in different stages of DR patients, and can provide reference for the evaluation of proliferative DR.更多还原