目的 检测新生血管性青光眼(NVG)患者房水中肝细胞生长因子(HGF)、中性粒细胞激活肽-78(ENA78)及信号素3A(Sema3A)的水平,并探讨其临床意义.方法 选取2018年1月至2023年1月许昌市人民医院收治的80例NGF患者作为观察组,均采用抗血管内皮生长因子(VEGF)治疗,其中治疗有效患者66例,治疗无效患者14例.另选取单纯行白内障手术的80例患者作为对照组.比较两组患者房水中HGF、ENA78及Sema3A水平,比较观察组抗VEGF治疗有效与无效患者临床资料及房水中HGF、ENA78、Sema3A水平,采用多因素Logistic回归分析NVG患者抗VEGF疗效的影响因素,采用受试者工作特征曲线(ROC)评价房水中HGF、ENA78及Sema3A对NVG患者抗VEGF疗效的预测价值.结果 观察组患者房水中HGF、ENA78及Sema3A分别为(847.56±128.41)ng/L、(185.36±25.41)ng/mL、(2.04±0.85)ng/mL,明显高于对照组的(488.92±98.25)ng/L、(84.29±17.37)ng/mL、(0.68±0.29)ng/mL,差异均有统计学意义(P<0.05);抗VEGF治疗有效与无效患者的一般资料比较差异均无统计学意义(P>0.05),抗VEGF治疗无效患者房水中HGF、ENA78及Sema3A分别为(974.22±154.33)ng/L、(218.83±31.22)ng/mL、(3.02±0.98)ng/mL,明显高于治疗有效患者的(820.69±118.21)ng/L、(178.26±18.33)ng/mL、(1.83±0.82)ng/mL,差异均有统计学意义(P<0.05);经多因素Logistic回归分析结果显示,房水中HGF、ENA78及Sema3A水平升高均为影响NVG患者抗VEGF疗效的危险因素(P<0.05);经ROC曲线分析结果显示,房水中HGF、ENA78及Sema3A联合检测预测NVG患者抗VEGF疗效的曲线下面积(AUC)值为0.921,明显高于房水中HGF、ENA78及Sema3A单独预测,差异均有统计学意义(P<0.05).结论 NVG患者房水中HGF、ENA78及Sema3A水平异常升高,且其为抗VEGF疗效的独立危险因素,检测三者水平有助于预测NVG患者抗VEGF疗效,为临床医师判断疾病治疗效果提供参考.
Objective To detect the levels of hepatocyte growth factor(HGF),neutrophil-activating pep-tide-78(ENA78),and semaphorin 3A(Sema3A)in the aqueous humor of patients with neovascular glaucoma(NVG),and to explore their clinical significance.Methods A total of 80 patients with NGF admitted to the Xuchang People's Hospital from January 2018 to January 2023 were selected as the observation group,all of whom were treated with an-ti-VEGF therapy,including 66 patients who responded effectively to treatment and 14 patients who did not respond effec-tively.A total of 80 patients who underwent cataract surgery alone were selected as the control group.The levels of HGF,ENA78,and Sema3A in the aqueous humor of the two groups of patients were compared.The clinical data and the levels of HGF,ENA78,and Sema3A in the aqueous humor of the patients in the observation group who responded effectively and ineffective to anti-VEGF therapy were compared.Multivariate logistic regression analysis was used to analyze the influencing factors of the anti-VEGF efficacy in NVG patients,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of HGF,ENA78,and Sema3A in the aqueous humor for the anti-VEGF effica-cy in NVG patients.Results The levels of HGF,ENA78,and Sema3A in the aqueous humor of the observation group were(847.56±128.41)ng/L,(185.36±25.41)ng/mL,and(2.04±0.85)ng/mL,respectively,significantly higher than(488.92±98.25)ng/L,(84.29±17.37)ng/mL,and(0.68±0.29)ng/mL of the control group(P<0.05).There was no statisti-cally significant difference in the general data between patients who responded effectively and those who did not respond effectively to anti-VEGF therapy(P>0.05).The levels of HGF,ENA78,and Sema3A in the aqueous humor of patients who did not respond effectively to anti-VEGF treatment were(974.22±154.33)ng/L,(218.83±31.22)ng/mL,and(3.02±0.98)ng/mL,respectively,significantly higher than(820.69±118.21)ng/L,(178.26±18.33)ng/mL,and(1.83±0.82)ng/mL in patients who responded effectively(P<0.05).Multiple logistic regression analysis showed that the levels of HGF,ENA78,and Sema3A in aqueous humor are all risk factors affecting the efficacy of anti-VEGF therapy in NVG patients(P<0.05).The AUC value of the combined detection of HGF,ENA78,and Sema3A in aqueous humor for pre-dicting anti-VEGF efficacy in NVG patients was 0.921,which was significantly higher than that of HGF,ENA78,and Sema3A alone(P<0.05).Conclusion The levels of HGF,ENA78,and Sema3A in aqueous humor of NVG patients are abnormally elevated,and they are independent risk factors for anti-VEGF efficacy.Detection of the levels of HGF,ENa78,and SEMA3A can help predict the anti-VEGF efficacy of NVG patients,which provides a reference for clini-cians to judge the efficacy of disease treatment.