Abstract:

Objective　To explore the influence of compstatin on the serum levels of human monocyte chemoattractant protein-1 (MCP-1) and placental growth factor (PlGF) in patients with diabetic retinopathy(DR). Methods　A prospective clinical study was conducted. One hundred and ninety-three patients with DR treated at Xi'an First Hospital from May 2020 to August 2022 were selected as the study objects. All the patients were treated with compstatin injection. One month after the treatment, the clinical efficacy was evaluated; the patients were categorized into a poor efficacy group (27 cases) and a good efficacy group (166 cases). There were 15 men and 12 women in the poor efficacy group; they were (53.14±9.45) years old; their DR course was (12.63±2.89) years. There were 86 men and 80 women in the good efficacy group; they were (51.86±9.72) years old; their DR course was (10.82±3.51) years. The clinical data and serum levels of MCP-1 and PlGF were compared between the two groups. The logistic regression was used to analyze the risk factors of the effect of compstatin injection for the patients with DR and to assess the efficacy of serum MCP-1 and PlGF in the prediction of the treatment effect. t and χ² tests were applied. Results　The diabetes mellitus duration and levels of glycosylated hemoglobin (HbA1c), vascular endothelial growth factor (VEGF), MCP-1, and PIGF in the poor efficacy group were higher those in the good efficacy group [(12.63±2.89) years vs. (10.82±3.51) years, (9.03±0.81)% vs. (8.52±0.94)%, (102.47±21.57) ng/L vs. (89.65±20.18) ng/L, (906.49±83.52) ng/L vs. (684.53±70.42) ng/L, and (75.83±9.25) ng/L vs. (62.01±8.43) ng/L], with statistical differences (t=2.541, 2.662, 3.032, 14.786, and 7.793; all P<0.05). The multifactorial regression analysis showed that HbA1C, VEGF, MCP-1, and PlGF were risk factors affecting the treatment effect of compstatin injection for the patients with DR (all P<0.05). The receiver operating characteristics curve analysis revealed that the areas under the curves of MCP-1, PIGF, and their combination in the prediction of the treatment effect of compstatin injection for the patients with DR were 0.833, 0.811, and 0.909, respectively. Conclusion　The combination of serum MCP-1 and PIGF is effective in predicting the therapeutic effect of compstatin injection for patients with DR.

Key words:

Diabetes retinopathy, Compstatin injection, Human monocyte chemoattractant protein-1, Placental growth factor, Efficacy evaluation

摘要：

目的　探讨康柏西普注射液对糖尿病视网膜病变（DR）患者血清人单核细胞趋化蛋白-1（MCP-1）、胎盘生长因子（PIGF）水平的影响。方法　前瞻性研究，选取2020年5月至2022年8月西安市第一医院收治的193例DR患者作为研究对象，所有患者均采用康柏西普玻璃腔内注射液治疗。治疗1个月后，评估临床治疗效果，并分为疗效不佳组（27例）和疗效良好组（166例）。疗效不佳组男15例、女12例，年龄（53.14±9.45）岁，糖尿病病程（12.63±2.89）年；疗效良好组男86例、女80例，年龄（51.86±9.72）岁，糖尿病病程（10.82±3.51）年。对比两组患者临床资料及血清MCP-1、PIGF水平，采用logistic回归分析康柏西普注射液对DR患者治疗效果的危险因素，以及血清MCP-1、PIGF水平对DR患者治疗效果的预测效能。采用t检验、χ²检验。结果　疗效不佳组糖尿病病程、糖化血红蛋白（HbA1c）、血管内皮生长因子（VEGF）、MCP-1、PIGF水平均高于疗效良好组［（12.63±2.89）年比（10.82±3.51）年、（9.03±0.81）%比（8.52±0.94）%、（102.47±21.57）ng/L比（89.65±20.18）ng/L、（906.49±83.52）ng/L比（684.53±70.42）ng/L、（75.83±9.25）ng/L比（62.01±8.43）ng/L］，差异均有统计学意义（t=2.541、2.662、3.032、14.786、7.793，均P<0.05）。logistic多因素回归分析显示，HbA1C、VEGF、MCP-1及PIGF水平均是影响DR患者康柏西普注射液治疗效果的危险因素（均P<0.05）。受试者操作特征曲线（ROC）分析结果显示，血清MCP-1、PIGF及二者联合对DR患者康柏西普注射液治疗效果预测的曲线下面积（AUC）分别为0.833、0.811、0.909。结论　康柏西普注射液治疗可降低DR患者血清MCP-1、PIGF水平，且二者联合治疗效果的预测效能较高。

关键词:

糖尿病视网膜病变, 康柏西普注射液, 人单核细胞趋化蛋白-1, 胎盘生长因子, 疗效评估