目的：探讨新生血管性青光眼(NVG)患者房水Apelin、δ样配体4(DLL4)表达水平与临床分期及疗效的关系。

方法：选取2022年1月至2024年3月我院收治的NVG患者96例96眼(NVG组)和同期在我院接受白内障手术的白内障患者96例96眼(对照组)。NVG患者根据临床分期分为Ⅰ期组(22眼)、Ⅱ期组(47眼)、Ⅲ期组(27眼)； 根据疗效分为无效组(20眼)和有效组(76眼)。采用酶联免疫吸附法检测房水Apelin、DLL4水平。通过多因素非条件Logistic回归分析NVG患者疗效的影响因素，受试者工作特征(ROC)曲线分析房水Apelin、DLL4水平对NVG患者疗效的评估效能。

结果：与对照组比较，NVG组房水Apelin、DLL4水平升高(均P<0.001)。Ⅰ期组、Ⅱ期组、Ⅲ期组房水Apelin、DLL4水平依次升高(均P<0.001)。96例NVG患者治疗有效率为79.2%(76/96)。与有效组比较，无效组房水Apelin、DLL4水平升高(均P<0.001)。临床分期Ⅲ期、眼压高、Apelin高、DLL4高为NVG患者治疗无效的危险因素(均P<0.05)。房水Apelin、DLL4水平联合评估NVG患者疗效的曲线下面积为0.874，大于房水Apelin、DLL4水平单独评估的0.790、0.786(均P<0.05)。

结论：NVG患者房水Apelin、DLL4水平升高，与临床分期增加和疗效较差有关，房水Apelin、DLL4水平联合评估NVG患者疗效的效能较高。

METHODS: A total of 96 NVG patients(96 eyes)who were admitted to our hospital from January 2022 to March 2024(NVG group)and 96 cataract patients(96 eyes)who underwent cataract surgery in our hospital during the same period(control group)were selected. NVG patients were divided into stage Ⅰ group(22 eyes), stage Ⅱ group(47 eyes)and stage Ⅲ group(27 eyes)according to the clinical stage; furthermore, patients were divided into ineffective group(20 eyes)and effective group(76 eyes)according to efficacy. Aqueous humor Apelin and DLL4 levels were detected by enzyme-linked immunosorbent assay. The influencing factors of the efficacy in NVG patients were analyzed by multivariate unconditional Logistic regression analysis, the evaluation efficiency of aqueous humor Apelin and DLL4 levels on the efficacy in NVG patients was analyzed by receiver operating characteristic(ROC)curve.

RESULTS: Compared with the control group, aqueous humor Apelin and DLL4 levels in the NVG group were increased(all P<0.001). Aqueous humor Apelin and DLL4 levels in the stage Ⅰ, stage Ⅱ and stage Ⅲ groups increased in turn(all P<0.001). The effective rate of 96 NVG patients was 79.2%(76/96). Compared with the effective group, aqueous humor Apelin and DLL4 levels in the ineffective group increased(all P<0.001). Clinical stage III, high intraocular pressure, high Apelin and DLL4 were independent risk factors for ineffective treatment in NVG patients(all P<0.05). The area under the curve of the combined evaluation of aqueous humor Apelin and DLL4 levels in evaluating the efficacy of NVG patients was 0.874, which was greater than 0.790 and 0.786 of aqueous Apelin and DLL4 levels alone(all P<0.05).

CONCLUSION: Aqueous humor Apelin and DLL4 levels in NVG patients increase, which relate to the increase of clinical stage and poor efficacy, and the combination of aqueous humor Apelin and DLL4 levels is more effective in evaluating the efficacy of NVG patients.