目的：探讨血清色素上皮衍生因子(PEDF)、成纤维细胞生长因子19(FGF19)、内啡肽(β-EP)在原发性青光眼患者诊断及严重程度评估中的应用价值。

方法：回顾性分析。选取2018-02/2020-02本院收治的原发性青光眼患者102例为研究组，选取同期体检健康者102名为对照组，比较两组受试者血清PEDF、FGF19、β-EP水平，分析其对原发性青光眼的诊断价值； 根据重度原发性青光眼诊断标准将研究组分为重度组与非重度组，比较两组患者血清PEDF、FGF19、β-EP水平，分析其对病情严重程度的评估价值； 采用多元Logistic回归分析影响原发性青光眼患者病情严重程度的危险因素。

结果：研究组血清PEDF水平明显低于对照组，FGF19、β-EP水平明显高于对照组(P<0.001)； PEDF、FGF19、β-EP水平诊断原发性青光眼的AUC分别为0.695、0.754、0.768； 重度组血清PEDF水平明显低于非重度组(P<0.001)，FGF19、β-EP水平明显高于非重度组(P<0.001)； PEDF、FGF19、β-EP水平评估原发性青光眼严重程度的AUC分别为0.731、0.709、0.685； PEDF<9.66pg/mL、FGF19>143.75ng/L、β-EP>106.27ng/L是原发性青光眼病情呈重度的独立影响因素(OR=2.280、1.570、1.413，均P<0.05)。

结论：FGF19、β-EP水平对原发性青光眼具有辅助诊断价值，PEDF、FGF19水平对病情严重程度具有评估价值，且PEDF<9.66pg/mL、FGF19>143.75ng/L、β-EP>106.27ng/L是原发性青光眼病情呈重度的独立影响因素。

METHODS: A total of 102 patients with primary glaucoma in the hospital were enrolled as study group between February 2018 and February 2020, while other 102 healthy controls during the same period were enrolled as control group. The levels of peripheral serum PEDF, FGF19 and β-EP were compared between the two groups. And their diagnostic value for primary glaucoma was analyzed. The study group was divided into severe and non-severe groups according to the diagnostic criteria for severe primary glaucoma. The levels of peripheral serum PEDF, FGF19 and β-EP were compared between severe group and non-severe group. And their evaluation value for disease severity was analyzed. The risk factors of disease severity were analyzed by multivariate Logistic regression analysis.

RESULTS: The level of serum PEDF in study group was significantly lower than that in control group, while levels of FGF19 and β-EP were significantly higher than those in control group(P<0.001). AUC values of PEDF, FGF19 and β-EP levels in the diagnosis of primary glaucoma were 0.695, 0.754 and 0.768, respectively. The level of serum PEDF in severe group was significantly lower than that in non-severe group(P<0.001), while levels of FGF19 and β-EP were significantly higher than those in non-severe group(P<0.001). AUCvalues of PEDF, FGF19 and β-EP levels in assessing the severity of primary glaucoma were 0.731, 0.709 and 0.685, respectively. PEDF lower than 9.66pg/mL, FGF19 higher than 143.75ng/L and β-EP higher than 106.27ng/L were independent influencing factors of severe primary glaucoma(OR=2.280, 1.570, 1.413, all P<0.05).

CONCLUSION: FGF19 and β-EP are of auxiliary diagnostic value in primary glaucoma, while PEDF and FGF19 are of evaluation value in disease severity. PEDF lower than 9.66pg/mL, FGF19 higher than 143.75ng/L and β-EP higher than 106.27ng/L are independent influencing factors of severe primary glaucoma.