青光眼术后并发滤过泡感染性眼内炎危险因素

Analysis of risk factors for infective endophthalmitis caused by filtering bleb in postoperative glaucoma patients

目的探讨青光眼术后患者并发滤过泡感染性眼内炎的危险因素。方法回顾性选取2014年1月-2019年12月台州市第一人民医院眼科收治的513例青光眼术后患者,根据患者术后是否并发滤过泡感染性眼内炎将其分为并发组(n=17)和未并发组(n=496)。回顾性分析两组临床资料;对比两组术后1 d的血清粒细胞集落刺激因子(G-CSF)、单核细胞趋化蛋白-1(MCP-1)、可溶性白细胞介素-2受体(sIL-2R)水平;对影响青光眼术后患者并发滤过泡感染性眼内炎的危险因素进行多因素Logistic回归分析。结果术后1 d,并发组血清G-CSF、MCP-1、sIL-2R水平均高于未并发组(P<0.05)。多因素Logistic回归分析结果显示,年龄≥60岁、男性、术中应用抗代谢药物、术中同步白内障手术、既往滤过手术≥1次、伴有糖尿病以及血清G-CSF、MCP-1、sIL-2R水平偏高是青光眼术后患者并发滤过泡感染性眼内炎的危险因素(OR=3.771、6.574、8.960、18.885、15.445、39.241、1.145、1.190、1.324,P<0.05)。结论血清G-CSF、MCP-1、sIL-2R在青光眼术后并发滤过泡感染性眼内炎患者中呈高表达,且青光眼术后并发滤过泡感染性眼内炎与患者年龄≥60岁、男性、术中应用抗代谢药物、术中同步白内障手术、既往滤过手术≥1次、伴有糖尿病及G-CSF、MCP-1、sIL-2R水平偏高有关,临床应当予以重视并采取相关措施以防止青光眼术后患者并发滤过泡感染性眼内炎。

OBJECTIVE To investigate the risk factors of postoperative glaucoma patients for infective endophthalmitis caused by filtering bleb.METHODS A total of 513 patients after glaucoma surgery in Department of Ophthalmology of Taizhou First People’s Hospital between Jan 2014 and Dec 2019 were enrolled and retrospective analyzed.They were divided into the complicated group(n=17)and the non-complicated group(n=496)according to whether the patients were complicated with bleb endophthalmitis after surgery and the clinical data of the two groups were retrospectively analyzed.The levels of serum granulocyte colony-stimulating factor(G-CSF),monocyte chemoattractant protein-1(MCP-1)and soluble interleukin-2 receptors(sIL-2 R)between the two groups 1-day after surgery were compared.Multivariate logistic regression analysis were used to analyze the risk factors for complicated infiltration endophthalmitis in patients after glaucoma surgery.RESULTS One day after surgery,the levels of serum G-CSF,MCP-1 and sIL-2 R in the complicated group were significantly higher than those in the non-complicated group(P<0.05).Multivariate Logistic regression analysis showed that age≥60 years old,male,intraoperative anti-metabolic drugs,intraoperative cataract surgery,previous filtration surgery≥1 times,with diabetes and the high levels of serum G-CSF,MCP-1 and sIL-2 R were the risk factors for the complicated infiltration endophthalmitis in patients after glaucoma surgery(OR=3.771;6.574;8.960;18.885;15.445;39.241;1.145;1.190;1.324,P<0.05).CONCLUSION Serum G-CSF,MCP-1 and sIL-2 R were highly expressed in patients with postoperative filtering bleb infective endophthalmitis after glaucoma surgery,which were associated with patient’s age≥60 years,male,intraoperative anti-metabolic drugs,intraoperative cataract surgery,previous filtration surgery≥1 times,diabetes,and high levels of G-CSF,MCP-1 and sIL-2 R.Clinical attention should be paid and relevant measures should be taken to prevent patients with after glaucoma surgery complicated with infiltration endophthalmitis.