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息肉样脉络膜血管病变继发玻璃体积血的全身危险因素。

Systemic Risk Factors for Vitreous Hemorrhage Secondary to Polypoidal Choroidal Vasculopathy.

作者信息

Liu Baoyi, Lai Kunbei, Ma Yuan, Gao Kai, Tsai Chinling, Li Jizhu, Wei Xiaoyue, Chen Ziye, Chen Zitong, Liu Yaping, Tuxun Rebiya, Li Tao

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China.

Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.

出版信息

Ophthalmol Ther. 2023 Oct;12(5):2769-2780. doi: 10.1007/s40123-023-00783-0. Epub 2023 Aug 9.

Abstract

INTRODUCTION

It remains unclear whether systemic factors are associated with an increased risk of vitreous hemorrhage (VH) secondary to polypoidal choroidal vasculopathy (PCV), and there is no method to predict the possibility of VH occurrence in patients with PCV. This study aimed to investigate and visualize systemic risk factors for VH in patients with PCV.

METHODS

Data on the sex, age, history of systematic diseases, best-corrected visual acuity, intraocular pressure, and laboratory data of patients with PCV were collected from the medical record system. Univariate and multivariate binary logistic regression analyses were applied to investigate independent risk factors for VH in patients with PCV. Receiver operating characteristic analysis and nomograms were used to visualize the independent risk factors.

RESULTS

The patient population comprised 115 patients with VH secondary to PCV and 181 patients with PCV without VH. Binary logistic regression analyses showed that higher white blood cell count [WBC; odds ratios (OR) 1.247], higher aspartate aminotransferase/alanine aminotransferase ratio (AST/ALT; OR 2.339), and longer activated partial thromboplastin time (APTT; OR 1.196) were independent risk factors of VH in patients with PCV. Integrated application of APTT, AST/ALT, and WBC as markers showed the best performance for distinguishing patients with VH, with an area under the curve of 0.723. The nomogram was created for doctors to calculate the possibility of VH in a patient with PCV.

CONCLUSIONS

Higher WBC, higher AST/ALT, and longer APTT are independent serum risk factors of VH secondary to PCV, which may shed light on VH prevention in patients with PCV.

摘要

引言

目前尚不清楚全身因素是否与息肉状脉络膜血管病变(PCV)继发玻璃体积血(VH)的风险增加相关,且尚无方法预测PCV患者发生VH的可能性。本研究旨在调查并可视化PCV患者发生VH的全身风险因素。

方法

从病历系统中收集PCV患者的性别、年龄、全身疾病史、最佳矫正视力、眼压及实验室数据。采用单因素和多因素二元逻辑回归分析来研究PCV患者发生VH的独立危险因素。采用受试者工作特征分析和列线图来可视化这些独立危险因素。

结果

患者群体包括115例PCV继发VH的患者和181例无VH的PCV患者。二元逻辑回归分析显示,较高的白细胞计数[WBC;比值比(OR)1.247]、较高的天冬氨酸转氨酶/丙氨酸转氨酶比值(AST/ALT;OR 2.339)以及较长的活化部分凝血活酶时间(APTT;OR 1.196)是PCV患者发生VH的独立危险因素。综合应用APTT、AST/ALT和WBC作为标志物在区分VH患者方面表现最佳,曲线下面积为0.723。创建了列线图供医生计算PCV患者发生VH的可能性。

结论

较高的WBC、较高的AST/ALT和较长的APTT是PCV继发VH的独立血清危险因素,这可能为PCV患者的VH预防提供线索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e34f/10442037/f447b9f58b57/40123_2023_783_Fig1_HTML.jpg

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