文章摘要
万鹏飞,贾俊,刘旭,等.视网膜静脉阻塞病人血清胶质纤维酸性蛋白和水通道蛋白 4水平变化及其与预后的关系[J].安徽医药,2024,28(6):1217-1220.
视网膜静脉阻塞病人血清胶质纤维酸性蛋白和水通道蛋白 4水平变化及其与预后的关系
Changes in serum GFAP and AQP4 levels in patients with retinal vein occlusion and their relationship with prognosis
  
DOI:10.3969/j.issn.1009-6469.2024.06.034
中文关键词: 视网膜静脉阻塞  胶质纤维酸性蛋白  水通道蛋白 4  预后  预测
英文关键词: Retinal vein occlusion  Glial fibrillary acidic protein  Aquaporin 4  Prognosis  Prediction
基金项目:
作者单位E-mail
万鹏飞 西安医学院第二附属医院眼科陕西西安 710038  
贾俊 西安医学院第二附属医院眼科陕西西安 710038  
刘旭 西安医学院第二附属医院眼科陕西西安 710038  
杨维佳 西安医学院第二附属医院眼科陕西西安 710038 396186250@qq.com 
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中文摘要:
      目的检测视网膜静脉阻塞( RVO)病人血清中胶质纤维酸性蛋白( GFAP)、水通道蛋白 4(AQP4)水平,探究二者表达水平与 RVO病人预后的关系。方法回顾性选取 2019年 8月至 2021年 8月西安医学院第二附属医院收治的 94例 RVO病人为研究组,另取同期体检健康者 85例为对照组。收集病人一般临床资料,对研究组和对照组的血清 GFAP、AQP4水平进行检测;根据研究组病人预后情况将其分为预后良好组( 39例)和预后不良组( 55例);多因素 logistic回归分析 RVO病人预后的影响因素;绘制血清 GFAP、AQP4对 RVO病人预后评估的受试者操作特征曲线( ROC曲线)。结果研究组血清 GFAP水平( 3.56±0.74)μg/L显著高于对照组( 1.85±0.41)μg/L,研究组血清 AQP4水平( 15.97±2.82)μg/L显著高于对照组( 10.56±2.54)μg/L(P<0.05)。预后不良组血清 GFAP水平(3.91±0.84)μg/L显著高于预后良好组( 3.06±0.62)μg/L;预后不良组血清 AQP4水平(17.25±3.29)μg/L显著高于预后良好组( 14.18±2.18)μg/L(P<0.05)。预后良好组与预后不良组病人高血压史、空腹血糖、总胆固醇(TC)、三酰甘油( TG)、高密度脂蛋白胆固醇( HDL-C)和低密度脂蛋白胆固醇( LDL-C)差异有统计学意义( P<0.05)。 logistic回归分析显示,血清 GFAP、AQP4、高血压史、空腹血糖、 TC、TG、LDL-C和 HDL-C均是 RVO病人预后不良的影响因素( P<0.05)。血清中 GFAP、AQP4、二者联合预测 RVO病人预后的 AUC分别是 0.73、0.79、0.92,灵敏度分别为 47.27%、78.85%、77.08%,特异度分别为 89.74%、72.97%、97.14%,约登指数分别为 0.370、0.518、0.742;二者联合优于 GFAP、AQP4各自单独预测(均 P<0.05)。结论 RVO病人血清 GFAP、AQP4水平显著升高,对病人的预后状况具有较高的预测效能,可为临床的合理干预和改善病人预后提供依据。
英文摘要:
      Objective To detect the serum levels of glial fibrillary acidic protein (GFAP) and aquaporin 4 (AQP4) in patients with retinal vein occlusion (RVO), and to explore the relationship between the expression levels of these two proteins and the prognosis of RVO patients.Methods A total of 94 RVO patients admitted to The Second Affiliated Hospital of Xi'an Medical College from August 2019to August 2021 were retrospectively selected as the study group, and another 85 healthy people who underwent physical examinationduring the same period composed the control group. The general clinical data of the patients were collected, and the serum GFAP andAQP4 levels in the study group and the control group were detected. The patients in the study group were divided into a good prognosisgroup (39 patients) and a poor prognosis group (55 patients). Multivariate logistic regression analysis was used to analyze the factors influencing the prognosis of RVO patients. Receiver-operating characteristic (ROC) curves of serum GFAP and AQP4 for the prognosis evaluation of RVO patients were generated.Results The serum GFAP concentration in the study group [(3.56 ± 0.74) μg/L] was significantly greater than that in the control group [(1.85 ± 0.41) μg/L], and the serum AQP4 concentration [(15.97 ± 2.82) μg/L] in the studygroup was significantly greater than that in the control group [(10.56 ± 2.54) μg/L] (P<0.05). The serum GFAP concentration in the poorprognosis group [(3.91 ± 0.84) μg/L] was greatly higher than that in the good prognosis group [(3.06 ± 0.62) μg/L]. Serum AQP4 concentration [(17.25 ± 3.29) μg/L] in the poor prognosis group was greatly higher than that in the good prognosis group [(14.18 ± 2.18) μg/L](P<0.05). There were significant differences in hypertension history, fasting blood glucose, total cholesterol (TC), triacylglycerol (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) between patients with a good prognosis and those with poor prognosis (P<0.05). Logistic regression revealed that differences in serum GFAP, AQP4, history of hypertension status, fasting blood glucose, TC , TG, LDL-C and HDL-C were all influential factors for poor prognosis in patients with RVO (P<0.05).The AUCs of serum GFAP, AQP4, and their combination in predicting the prognosis of patients with RVO were 0.73, 0.79, and 0.92, respectively, with sensitivities of 47.27%, 78.85%, and 77.08%, specificities of 89.74%, 72.97%, and 97.14%, and Yoden indices of0.370, 0.518, and 0.742, respectively; the two combinations were superior to the predictions of each of GFAP and AQP4 alone (all P< 0.05).Conclusion The serum GFAP and AQP4 levels in RVO patients were greatly increased, which is highly predictive of patientprognosis of patients, and could provide a basis for rational clinical intervention and improvement of the patient prognosis.
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