血管内皮生长因子与糖尿病黄斑囊样水肿严重程度的相关性

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中图分类号：R774.1 文献标志码：A DOI：10.11958/20250186

Abstract：ObjectiveTo investigate thecorrelation between serum vascular endothelial growth factor （VEGF）level andthedevelopmentand severityof diabetes melltus cystoid macular edema （CME）.MethodsAtotal of 57patients （57 eyes）with diabetic CME （the case group）and diabetes without eyecomplications （the control group）admitted to the VitreoretinalSurgeryDepartmentofTangshanEyeHospitalfromJuneO23toJune2O24wereprospectivelyselected，ndll of them underwent systematic ophthalmic specialty examination and serum VEGFdetection.Multivariate Logistic regression analysiswasused to identify therisk factorsof diabetes melitus CME.Te diagnostic valueof VEGF in patients with diabetes CME was analyzed by receiver operating characteristic （ROC）curve.Spearman corelation was used to analyze the relationshipbetween VEGFlevelsandtheseverityofCMEinpatientswithdiabetes，suchascorrctedvisual，numberof cystoid edema and non-round index of macularfoveal avascular zone （FAZ）.ResultsCompared with thecontrol group，the courseofdiabetes inthecase group waslonger，the incidenceof hypertension was higher，levelsof glycosylated hemoglobin （HbA1c），serum creatinine and serum VEGF were higher，and the estimated glomerularfiltrationrate （eGFR）was lower（ P< 0.05）.Multivariate Logistic regression results showedthatlong duration of diabetes，increased levels of HbAlc and VEGF were risk factors for CME in diabetes melitus patients，whileelevated eGFR wasprotective factor （ P<0.05 ）. ROC curve analysis showed that the areaunderthe curve （AUC）of VEGF in diagnosing diabetes mellitus CME was0.758（ 95%CI

0.669-0.834）.The AUCof thecombined applicationof diabetes duration，HbAlc，eGFRand VEGF in the diagnosis of diabetesmelltus CMEwas 0.916（95%CI：0.877-0.941），which wassignificantly higher than thatof theapplicationof VEGF alone （ P<0.05 ）.The VEGFlevel was negatively correlated with the corrected visualacuity [0.34（O.24，0.44）] inpatients with diabeticCME，andpositivelycorrelatedwiththedetectionofcystoidmacularedema[3（2，5）]andFAZnon-roundness index [1.16 （1.08，1.20）] （rs were 0.771，0.700，respectively， P<0.05 ）. ConclusionSerum VEGF levels are closely related to the onsetandseverityofCME，and which can be used asareliable reference index forthe diagnosis of CME.

KeyWwords： diabetes mellitus; macular edema; vascular endothelial growth factors; severity

黄斑囊样水肿（CME）是临床常见的眼底疾病，糖尿病视网膜病变（DR）是CME的常见病因。（剩余10384字）