目的：探究糖尿病视网膜病变(DR)患者血清三叶因子1(TFF1)、膜联蛋白A2(ANXA2)表达及其诊断价值。

方法：选择2022年1月至2024年12月于本院就诊的DR患者50例100眼为研究组，未合并视网膜病变的T2DM患者50例100眼为对照组，酶联免疫法测定血清TFF1、ANXA2表达； Pearson分析DR患者血清TFF1与ANXA2的表达相关性； Logistics分析T2DM患者发生视网膜病变的影响因素； ROC曲线分析血清TFF1、ANXA2表达对DR患者诊断价值。

结果：研究组T2DM病程、糖化血红蛋白、总胆固醇(TC)、血清ANXA2表达明显高于对照组(均P<0.001)； 研究组血清TFF1表达明显低于对照组(P<0.001)； DR患者血清TFF1与ANXA2表达呈负相关(r=-0.345，P=0.014)； 血清TFF1、ANXA2表达是T2DM患者发生视网膜病变的影响因素(均P<0.05)； 血清TFF1诊断DR的AUC为0.831(95%CI=0.746-0.916)，血清ANXA2诊断DR的AUC为0.832(95%CI=0.755-0.908)，两者联合诊断DR的AUC为0.932(95%CI=0.884-0.980)，血清TFF1、ANXA2联合诊断DR的价值高于单独诊断(Z_{两者联合-TFF1}=2.883，P=0.004； Z_{两者联合-ANXA2}=2.947，P=0.003)。

结论：DR患者血清TFF1表达降低，血清ANXA2表达升高； 血清TFF1表达降低、ANXA2表达升高与T2DM患者发生视网膜病变的风险增加有关，血清TFF1、ANXA2联合对DR有一定诊断价值。

METHODS:A total of 50 DR patients(100 eyes; research group)and 50 type 2 diabetes mellitus(T2DM)patients(100 eyes; control group)without retinopathy who visited our hospital between January 2022 and December 2024 were recruited. Enzyme linked immunosorbent assay was performed to test serum TFF1 and ANXA2. Pearson method was performed to analyze the correlation between serum TFF1 and ANXA2 in DR. Logistics method was used to discuss the influencing factors of retinopathy in T2DM patients. ROC was performed to analyze the diagnostic value of serum TFF1 and ANXA2 in DR.

RESULTS: The research group had clearly longer T2DM course, higher glycated hemoglobin, total cholesterol(TC), and serum ANXA2 than the control group(all P<0.001); the research group had significantly lower serum TFF1 than the control group(P<0.001); Serum TFF1 and ANXA2 in DR patients were negatively correlated(r=-0.345, P=0.014). The expression of serum TFF1 and ANXA2 was influencing factor for the occurrence of retinopathy in T2DM patients(all P<0.05). The AUC of serum TFF1 in diagnosing DR was 0.831(95%CI=0.746-0.916), and the AUC of serum ANXA2 in diagnosing DR was 0.832(95%CI=0.755-0.908). The combination of the two had an AUC of 0.932(95%CI=0.884-0.980)for diagnosing DR. The combination of serum TFF1 and ANXA2 had a higher diagnostic value for DR than individual diagnosis(Z_{combination-TFF1}=2.883, P=0.004; Z_{combination-ANXA2}=2.947, P=0.003).

CONCLUSION: Serum TFF1 is reduced and serum ANXA2 is increased in DR patients. These changes are associated with the increase in risk of retinopathy in T2DM. The combination of serum TFF1 and ANXA2 has certain diagnostic value for DR.