目的：分析血清人新饱食分子蛋白-1(nesfatin-1)、爱帕琳肽(apelin)、血红素氧合酶-1(HO-1)水平与糖尿病视网膜病变(DR)严重程度的相关性。

方法：选取2020-09/2022-09我院收治的2型糖尿病(T2DM)患者100例，根据眼底病变情况分为无DR(NDR)组(35例)、NPDR组(33例)、PDR组(32例)。另选取同期于本院进行健康体检者30例作为对照组。检测并分析各组研究对象血清nesfatin-1、apelin、HO-1水平，评估DR患者的全视网膜缺血指数(ISI)。

结果：T2DM患者血清nesfatin-1、HO-1水平均低于对照组，apelin水平均高于对照组，且PDR组血清nesfatin-1、HO-1水平最低，而apelin水平最高。PDR组全视网膜ISI高于NPDR组(4.56±0.57 vs 2.05±0.29，P<0.05)。相关性分析显示，DR患者血清nesfatin-1、HO-1水平与全视网膜ISI均呈负相关，而apelin水平与全视网膜ISI呈正相关。受试者工作特征曲线(ROC)分析显示，血清nesfatin-1、apelin、HO-1预测PDR曲线下面积分别为0.842、0.833、0.807。

结论：血清nesfatin-1、apelin、HO-1水平与DR严重程度有密切关系，动态监测血清nesfatin-1、apelin、HO-1水平对及早发现PDR具有重要意义。

METHODS:Totally 100 patients with type 2 diabetes mellitus(T2DM)who were admitted to the hospital from September 2020 to September 2022 were selected. They were divided into non-DR(NDR)group(35 cases), nonproliferative DR(NPDR)group(33 cases)and proliferative DR(PDR)group(32 cases)according to the condition of fundus lesions. Another 30 healthy individuals who received health check-ups in the hospital during the same period were selected as the control group. Serum nesfatin-1, apelin and HO-1 levels in each group were detected, and panretinal ischemia index(ISI)was evaluated.

RESULTS:Serum nesfatin-1 and HO-1 levels in the T2DM patients were lower, and apelin level was higher as compared with the control group. The levels of nesfatin-1 and HO-1 in the PDR group were the lowest, while the apelin level was the highest. Panretinal ISI in the PDR group was higher than that in the NPDR group(4.56±0.57 vs. 2.05±0.29, P<0.05). Correlation analysis found that serum nesfatin-1 and HO-1 levels were negatively correlated with panretinal ISI in patients with DR, while apelin level was positively correlated with panretinal ISI. The receiver operator characteristic(ROC)curve analysis found that the areas under the curves of serum nesfatin-1, apelin and HO-1 for predicting PDR were 0.842, 0.833 and 0.807 respectively.

CONCLUSION:Serum nesfatin-1, apelin and HO-1 levels are closely related to the severity of DR. Dynamic monitoring of serum nesfatin-1, apelin and HO-1 levels is important for the early detection of PDR.