方法：选取2019-07/2021-07本院收治的糖尿病视网膜病变(DR)患者160例，根据病变程度分为PDR组(80例)和非增生性糖尿病视网膜病变(NPDR)组(80例)，同时选取本院100例健康体检者为对照组。检测并比较所有研究对象血清中甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)水平； 采用实时荧光定量PCR(qRT-PCR)法检测血清中LncRNA HIF1A-AS1表达水平； 通过Logistic回归分析影响PDR发生的危险因素； 利用受试者工作特征曲线(ROC)分析LncRNA HIF1A-AS1水平诊断PDR的临床价值。

结果：PDR组患者血清中LncRNA HIF1A-AS1表达水平明显高于NPDR组和对照组，NPDR组高于对照组(P<0.05)； PDR组、NPDR组患者糖尿病病程、HbA1c、TC、TG、LDL-C、FBG水平显著高于对照组，PDR组HDL-C水平显著低于对照组(P<0.05)； LncRNA HIF1A-AS1水平与糖尿病病程、HbA1c、TC、TG、LDL-C、FBG呈正相关(P<0.05)，与HDL-C呈负相关(P<0.05)。Logistic回归分析结果显示，LncRNA HIF1A-AS1、病程、FBG、HbA1c、TC、TG、LDL-C均是PDR发生的危险因素(P<0.05)。ROC结果显示，LncRNA HIF1A-AS1水平预测PDR发生的曲线下面积(AUC)为0.766(95%CI：0.692～0.829)，对应的敏感度为66.25%，特异度为78.75%。

结论：PDR患者血清中LncRNA HIF1A-AS1水平上调，是PDR发生的危险因素，且可作为预测PDR发生的潜在血清学指标。

METHODS: A total of 160 patients with diabetic retinopathy(DR)admitted to our hospital from July 2019 to July 2021 were selected as the research objects. According to the degree of disease, they were divided into PDR group(80 cases)and nonproliferative diabetic retinopathy(NPDR)group(80 cases). At the same time, 100 healthy cases in our hospital were selected as the control group. Detect and compare serum triglyceride(TG), total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), fasting blood glucose(FBG)and the level of glycosylated hemoglobin A1c(HbA1c); The expression level of LncRNA HIF1A-AS1 in serum was detected by real-time fluorescence quantitative PCR(qRT-PCR)method; Logistic regression was used to analyze the risk factors that affected the occurrence of PDR; Receiver operating characteristic curve(ROC)was used to analyze the clinical value of LncRNA HIF1A-AS1 level in the diagnosis of PDR.

RESULTS: The expression level of LncRNA HIF1A-AS1 in the serum of the patients in the PDR group was significantly higher than that in the NPDR group and the control group, and the NPDR group was higher than the control group(P<0.05); The course of disease, HbA1c, TC, TG, LDL-C, FBG levels in the PDR group and the NPDR group were significantly higher than those of the control group, the HDL-C level in the PDR group was significantly lower than that in the control group(P<0.05); The level of LncRNA HIF1A-AS1 was positively correlated with the course of disease, HbA1c, TC, TG, LDL-C and FBG(P<0.05), and negatively correlated with HDL-C(P<0.05); Logistic regression analysis showed that the LncRNA HIF1A-AS1, course of disease, FBG, HbA1c, TC, TG, LDL-C were all risk factors for PDR(P<0.05); ROC results showed that the area under the curve(AUC)of the LncRNA HIF1A-AS1 level predicting PDR was 0.766(95%CI: 0.692～0.829), the corresponding sensitivity was 66.25% and the specificity was 78.75%.

CONCLUSION: The level of LncRNA HIF1A-AS1 in the serum of PDR patients is up-regulated, it is a risk factor for the occurrence of PDR and it can be used as a potential serological indicator for predicting the occurrence of PDR.