目的：探讨血清正五聚蛋白3(PTX3)、脂肪酸结合蛋白4(FABP4)、脯氨酸羟化酶2(PHD2)水平与糖尿病性黄斑水肿(DME)严重程度的相关性。

方法：选取本院2022年3月至2025年3月收治的DME患者157例(DME组)，根据患者病情程度分为轻、中、重度组，另选取同期本院收治的单纯T2DM患者157例(T2DM组)。采用ELISA检测血清PTX3、FABP4、PHD2水平； 采用Logistic分析重度DME的影响因素； 绘制ROC曲线分析血清PTX3、FABP4、PHD2对重度DME患者的评估价值。

结果：T2DM组和DME组糖尿病病程、空腹血糖、糖化血红蛋白、同型半胱氨酸比较有差异(均P<0.05)。与T2DM组相比，DME组血清PTX3、FABP4、PHD2水平明显升高(均P<0.05)。与轻度组相比，中度组和重度组血清PTX3、FABP4、PHD2水平明显升高(均P<0.05)； 与中度组相比，重度组血清PTX3、FABP4、PHD2水平明显升高(均P<0.05)。Logistic分析PTX3、FABP4、PHD2为影响重度DME的危险因素(均P<0.05)。ROC曲线结果显示：血清PTX3、FABP4、PHD2单独及联合评估重度DME患者的AUC为0.788、0.802、0.814、0.957，联合评估的AUC高于各自单独评估(Z=2.696、2.711、2.714，均P<0.05)。

结论：DME患者血清PTX3、FABP4、PHD2水平均明显升高，三者与患者病情程度有关，联合检测对评估重度DME患者有一定的临床价值。

METHODS:A total of 157 DME patients admitted to our hospital from March 2022 to March 2025 were selected as the DME group, categorized into mild, moderate, and severe groups based on the severity of their condition. Additionally, 157 patients with simple T2DM during the same period were also selected as the T2DM group. ELISA was used to detect serum levels of PTX3, FABP4, and PHD2; Logistic analysis was conducted to identify factors affecting severe DME; and ROC curves were drawn to analyze the evaluation value of serum PTX3, FABP4, and PHD2 in patients with severe DME.

RESULTS: There were differences between the T2DM group and the DME group in the duration of diabetes, fasting blood sugar, glycated hemoglobin, and homocysteine levels(all P<0.05). Compared with the T2DM group, the serum levels of PTX3, FABP4, and PHD2 in the DME group were significantly elevated(all P<0.05). In comparison to the mild group, the moderate and severe groups had significantly higher serum levels of PTX3, FABP4, and PHD2(all P<0.05). Compared with the moderate group, the severe group had significantly higher serum levels of PTX3, FABP4, and PHD2(all P<0.05). Logistic analysis showed that PTX3, FABP4, and PHD2 are risk factors affecting severe DME(all P<0.05). The results of the ROC curve indicated that the AUCs for the individual and combined evaluations of serum PTX3, FABP4, and PHD2 in severe DME patients were 0.788, 0.802, 0.814, and 0.957, respectively, with the combined evaluation having a higher AUC than the individual evaluation(Z=2.696, Z=2.711, Z=2.714, all P<0.05).

CONCLUSION: Serum levels of PTX3, FABP4, and PHD2 are significantly elevated in patients with DME, and the three are associated with the severity of the patients' condition. Combined testing has a certain clinical value in assessing patients with severe DME.