血清SAA、PCT及IL-1β联合检测在白内障术后眼内炎临床诊断中的应用

Application of combined detection of serum SAA,PCT and IL-1βin the clinical diagnosis of endophthalmitis after cataract surgery

目的分析血清淀粉样蛋白A(SAA)、降钙素原(PCT)及白介素-1β(IL-1β)联合检测在白内障术后临床诊断中的应用效果。方法选择2020年5月至2023年1月于枣阳市第一人民医院行手术治疗的白内障患者152例,另选取同期于本院行体检的健康人群136名为对照组。比较两组血清SAA、PCT及IL-1β水平;观察组根据术后感染情况分未感染组及未感染组,比较两组一般资料及血清SAA、PCT及IL-1β水平。采用二元Logistic回归分析影响白内障术后眼内炎感染的危险因素。比较SAA、PCT及IL-1β三指标单独检测和联合检测对眼内炎的检测阳性率。采用Pearson相关性分析血清SAA、PCT及IL-1β之间的关系。结果观察组血清SAA、PCT及IL-1β水平均显著高于对照组,差异有统计学意义(P<0.05)。感染组30例,未感染组122例。两组性别、年龄、既往疾病史、饮酒史、手术时长比较差异无统计学意义(P>0.05)。两组吸烟史、术中出血量、玻璃体溢出、血清SAA、PCT及IL-1β水平比较差异具有统计学意义(P<0.05)。经二元Logistic回归分析可知,有吸烟史、术中出血量高、有玻璃体溢出、血清SAA、PCT及IL-1β水平异常均是影响白内障术后眼内炎感染的危险因素(P<0.05)。SAA、PCT及IL-1β单一检测阳性率分别为78.28%、71.05%及69.73%,三者联合检测阳性率为92.76%(P<0.05)。术后3d血清SAA、PCT分别与IL-1β水平均呈正相关(r=0.743、0.682,P<0.05),血清SAA水平与PCT水平呈正相关(r=0.638,P<0.05)。结论白内障术后眼内炎中血清SAA、PCT及IL-1β水平显著上升,三指标是影响白内障术后眼内炎感染的主要危险因素,三指标联合检测在白内障术后眼内炎临床诊断价值高,可为临床后续治疗及预后风险提供参考依据。

Objective To evaluate the application efficacy of Serum amyloid A(SAA),procalcitonin(PCT)and interleukin-1β(IL-1β)combined detection in the clinical diagnosis after cataract surgery.Methods 152 patients with cataract underwent surgery in Zaoyang First People's Hospital from May 2020 to January 2023 were selected,and 136 healthy people who underwent physical examination in our hospital during the same period were selected as the control group.Serum levels of SAA,PCT and IL-1β were compared between the two groups;the observation group was divided into the uninfected group and the uninfected group according to the postoperative infection,and the general data and serum levels of SAA,PCT and IL-1β were compared between the two groups.The risk factors of endophthalmitis infection after cataract surgery were analyzed by binary Logistic regression.The positive rate of endophthalmitis detected by single detection and combined detection was compared.The relationship between serum SAA,PCT and IL-1β was analyzed by Pearson correlation.Results The serum levels of SAA,PCT and IL-1β in observation group were significantly higher than those in control group,and the difference was statistically significant(P<0.05).There were 30 cases in the infected group and 122 cases in the uninfected group.There were no statistically significant differences in gender,age,previous disease history,drinking history and operation duration between the two groups(P>0.05).There were significant differences in smoking history,intraoperative blood loss,vitreous overflow,serum SAA,PCT and IL-1β levels between the two groups(P<0.05).Binary Logistic regression analysis showed that smoking history,high intraoperative blood loss,vitreous overflow,abnormal serum SAA,PCT and IL-1β levels were risk factors affecting endophthalmitis infection after cataract surgery(P<0.05).The positive rate of SAA,PCT and IL-1β was 78.28%,71.05% and 69.73%,respectively,the positive rate of combined detection was 92.76%(P<0.05).3 days after operation,serum SAA and PCT were positively correlated with IL-1β levels(r=0.743,0.682,P<0.05),and serum SAA level was positively correlated with PCT level(r=0.638,P<0.05).Conclusion Serum levels of SAA,PCT and IL-1β increased significantly in postoperative endophthalmitis,and the three indicators are the main risk factors affecting postoperative endophthalmitis infection,the combined detection of the three indicators is of high value in the clinical diagnosis of postoperative endophthalmitis,which can provides a reference for clinical follow-up treatment and prognostic risk.