目的：探讨糖尿病视网膜病变(DR)患者血清中沉默信息调节因子2相关酶1(SIRT1)、血管生长抑制因子-2(Vasostatin-2)含量与病变的相关性分析。方法：选取2021年4月至2024年4月本院收治的DR患者104例104眼即为DR组，根据不同病变分期分为非增殖性DR(NPDR)组44例44眼和增殖性DR(PDR)组60例60眼。同期收治单纯糖尿病患者104例104眼为非DR组。采用ELISA法检测血清中SIRT1、Vasostatin-2水平。ROC曲线分析血清SIRT1、Vasostatin-2水平对DR的诊断价值。多因素Logistic回归分析影响DR发生的因素。Pearson相关性分析分析DR患者血清中SIRT1、Vasostatin-2含量与血管生成指标(VEGF、Ang-2)的关系。结果：与非DR组相比，DR组患者血清中SIRT1、Vasostatin-2水平均显著降低(P<0.05)。与NPDR组相比，PDR组患者血清中SIRT1、Vasostatin-2水平均显著降低(P<0.05)。与非DR组相比，DR组患者血清中VEGF、Ang-2水平均显著升高(P<0.05)。与血清SIRT1、Vasostatin-2水平单独检测相比，联合检测对DR诊断的AUC显著升高(Z=4.180、5.128，均P<0.05)。多因素Logistic回归分析显示，HOMA-IR(OR=3.455)、空腹血糖(OR=1.467)、SIRT1(OR=0.836)、Vasostatin-2(OR=0.767)、VEGF(OR=2.564)、Ang-2(OR=1.834)水平是DR发生的影响因素(均P<0.05)。Pearson相关性分析显示，DR患者血清中SIRT1、Vasostatin-2含量与VEGF、Ang-2均呈负相关关系(rSIRT1 vs VEGF=-0.395、rSIRT1 vs Ang-2=-0.474、rVasostatin-2 vs VEGF=-0.323、rVasostatin-2 vs Ang-2=-0.583，均P<0.001)。结论：DR患者血清SIRT1、Vasostatin-2水平异常降低，与DR病变分期及血管生成密切相关。

AIM: To investigate the correlation of serum Silent mating-type information regulation 2 homolog 1(SIRT1)and Vasostatin-2 content with pathological changes in diabetic retinopathy(DR)patients.METHODS: A total of 104 DR patients(104 eyes)admitted to our hospital from April 2021 to April 2024 were included as the DR group. According to different disease stages, they were assigned into a non-proliferative DR(NPDR)group of 44 cases(44 eyes)and a proliferative DR(PDR)group of 60 cases(60 eyes). Meantime, 104 patients(104 eyes)with simple diabetes were treated as non-DR group. ELISA was applied to detect the levels of SIRT1 and Vasostatin-2 in serum. The diagnostic value of serum SIRT1 and Vasostatin 2 in DR was analyzed by ROC curve. Multivariate Logistic regression was applied to analyze the factors that affected the occurrence of DR. Pearson correlation was applied to analyze the relationship between the levels of SIRT1 and Vasostatin-2 in the serum of DR patients and angiogenesis indicators(VEGF, Ang-2).RESULTS: Compared with the non-DR group, the levels of SIRT1 and Vasostatin-2 in the serum of the DR group were significantly decreased(P<0.05). Compared with the NPDR group, the levels of SIRT1 and Vasostatin-2 in the serum of the PDR group were significantly decreased(P<0.05). Compared with the non-DR group, the levels of VEGF and Ang-2 in the serum of the DR group were obviously higher(P<0.05). Compared with the single detection of serum SIRT1 and Vasostatin-2 levels, combined detection significantly increased the AUC in the diagnosis of DR(Z=4.180, 5.128, all P<0.05). Multivariate Logistic regression analysis showed that HOMA-IR(OR=3.455), fasting blood glucose(OR=1.467), SIRT1(OR=0.836), Vasostatin-2(OR=0.767), VEGF(OR=2.564), and Ang-2(OR=1.834)levels were the influencing factors on the occurrence of DR(all P<0.05). Pearson correlation analysis showed that the levels of SIRT1 and Vasostatin-2 in the serum of DR patients were negatively correlated with VEGF and Ang-2(rSIRT1 vs VEGF=-0.395, rSIRT1 vs Ang-2=-0.474, rVasostatin-2 vs VEGF=-0.323, rVasostatin-2 vs Ang-2=-0.583, all P<0.001).CONCLUSION: The abnormal decrease of serum SIRT1 and Vasostatin 2 levels in DR patients is closely related to the stage of DR lesions and angiogenesis.

2019年度中医药类科研计划课题(No.2019444)