目的:我们的研究旨在探讨血管内皮生长因子(VEGF)NOD样受体热蛋白结构域相关蛋白3(NLRP3)炎性复合物,促红细胞生成素(EPO)水平,诊断为原发性开角型青光眼(POAG)患者的眼部血流动力学。
方法:这是一项前瞻性观察性研究。选择2022年11月至2030年2月在武汉医院第六医院诊断为POAG的患者。根据平均视野缺损将患者分为三组(平均偏差,MD)值:严重损伤组(MD>12dB,93例),中度损伤组(7≤MD≤12dB,89例),和轻度损伤组(MD<7dB,85例)。VEGF的水平,NLRP3炎性复合物,EPO,并比较各组眼血流动力学。此外,VEGF之间的关系,NLRP3,EPO水平,采用Pearson相关分析法对POAG患者的眼部血流动力学进行分析。在调整了年龄和性别等混杂因素后,以眼血流动力学指标为因变量进行多因素Logistic回归分析,和VEGF,NLRP3,ASC,使用Caspase-1和EPO作为独立变量。
结果:共纳入267例POAG患者。性别没有显著差异,年龄,身体质量指数,收缩压,舒张压,吸烟,酒精消费,两组血糖水平比较(P>0.05)。NLRP3、ASC、重度和中度损伤组的Caspase-1和EPO高于轻度损伤组,与轻度组相比,重度和中度组的VEGF水平较低,差异显著(P<0.05)。严重组NLRP3、ASC、Caspase-1和EPO比中度组,而重度组的VEGF水平低于中度组,差异显著(P<0.05)。重度和中度组收缩期峰值速度(PSV)和阻力指数(RI)均高于轻度组,而重度和中度组的EDV明显低于轻度组(P<0.05)。重度组的PSV和RI值高于中度组,而重度组的EDV低于中度组,差异显著(P<0.05)。进行Pearson相关分析以检查VEGF,NLRP3,EPO水平,POAG患者的眼部血流动力学。VEGF,NLRP3,ASC,Caspase-1和EPO与PSV和RI呈正相关,POAG患者与EDV呈负相关。回归分析显示,VEGF,NLRP3,ASC,Caspase-1和EPO与POAG的眼部血流动力学显著相关(均P<0.001)。
结论:我们证明了VEGF的水平,NLRP3炎性复合物,在诊断为POAG的患者中,EPO与眼部血流动力学高度相关。
OBJECTIVE: Our study aimed to investigate the relationship between vascular endothelial growth factor (VEGF), NOD-like receptor thermal protein domain associated protein 3 (NLRP3) inflammatory complex, erythropoietin (EPO) levels, and ocular hemodynamics in patients diagnosed with primary open-angle glaucoma (POAG).
METHODS: This is a prospective observational study. Patients diagnosed with POAG at The Sixth Hospital of Wuhan hospital between November 2022 and February 2023were enrolled.The patients were categorized into three groups based on the average visual field defect (mean deviation, MD) value: severe injury group (MD > 12 dB, 93 cases), moderate injury group (7 ≤ MD ≤ 12 dB, 89 cases), and mild injury group (MD < 7 dB, 85 cases). The levels of VEGF, NLRP3 inflammatory complex, EPO, and ocular hemodynamics were compared among the groups. Furthermore, the relationship between VEGF, NLRP3, EPO levels, and ocular hemodynamics in patients with POAG was analyzed using Pearson correlation analysis. After adjusting for confounding factors such as age and gender, multivariate Logistic regression analysis was performed with the ocular hemodynamics indexes being used as dependent variables, and VEGF, NLRP3, ASC, Caspase-1, and EPO being used as independent variables.
RESULTS: A total of267 patients with POAG were enrolled. There were no significant differences in sex, age, body mass index, systolic blood pressure, diastolic blood pressure, smoking, alcohol consumption, and blood glucose between the two groups (P > 0.05). The levels of NLRP3, ASC, Caspase-1, and EPO in the severe and moderate injury groups were higher than those in the mild injury group, whereas the VEGF levels were lower in the severe and moderate groups compared to the mild group, showing significant differences (P < 0.05). The severe group exhibited higher levels of NLRP3, ASC, Caspase-1, and EPO than the moderate group, while the VEGF levels were lower in the severe group compared to the moderate group, showing significant differences (P < 0.05). The peak systolic velocity(PSV) and resistance index (RI) were higher in the severe and moderate groups than in the mild group, whereas the EDV was significantly lower in the severe and moderate groups compared to the mild group (P < 0.05). The severe group exhibited higher PSV and RI values compared to the moderate group, while the EDV was lower in the severe group compared to the moderate group, showing significant differences (P < 0.05). Pearson correlation analysis was performed to examine the relationship between VEGF, NLRP3, EPO levels, and ocular hemodynamics in patients with POAG. VEGF, NLRP3, ASC, Caspase-1, and EPO showed positive correlations with PSV and RI, and negative correlations with EDV in patients with POAG. Regression analysis showed that VEGF, NLRP3, ASC, Caspase-1 and EPO were significantly correlated with ocular hemodynamics in POAG (all P < 0.001).
CONCLUSIONS: We demonstrated that the levels of VEGF, NLRP3 inflammatory complex, and EPO were highly associated with ocular hemodynamics in patients diagnosed with POAG.