白内障术后感染性眼内炎危险因素及血清sTREM-1、HMGB1、CD64指数的诊断价值

Risk factors for postoperative infectious endophthalmitis in cataract patients and diagnostic values of serum sTREM-1,HMGB1 and CD64 indexes

目的探究白内障术后感染性眼内炎危险因素及血清可溶性髓系细胞触发受体-1(sTREM-1)、高迁移率族蛋白1(HMGB1)、CD64指数的诊断价值.方法回顾性收集2020年12月-2022年12月于绍兴市中心医院行白内障手术患者420例的临床资料,根据术后情况分为并发感染性眼内炎组30例和未并发感染性眼内炎组390例.统计感染患者病原菌分布,分析危险因素,比较血清sTREM-1、HMGB1、CD64指数变化,分析其对白内障术后感染性眼内炎的诊断价值.结果420例白内障手术患者术后并发感染性眼内炎30例(7.14%);共分离出34株病原菌,其中革兰阳性菌31株(91.18%).白内障术后并发感染性眼内炎的危险因素为年龄大、有糖尿病、手术时间(≥15 min)(P<0.05).并发感染性眼内炎组sTREM-1、HMGB1、CD64指数高于未并发感染性眼内炎组(P<0.05),三者联合检测对白内障术后并发感染性眼内炎的诊断曲线下面积(AUC)高于单独检测(P<0.05),敏感度和特异度分别为96.67%、82.31%.结论白内障手术患者术后并发感染性眼内炎发生率高,以革兰阳性菌为主,年龄大、有糖尿病、手术时间(≥15 min)为白内障术后并发感染性眼内炎危险因素;sTREM-1、HMGB1、CD64指数在白内障手术患者术后并发感染性眼内炎中升高,三者联合检测对其具有较高诊断价值.

OBJECTIVE To explore the risk factors for postoperative infectious endophthalmitis in cataract patients and analyze the diagnostic values of serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1),high-mobility group box 1(HMGB1)and CD64 indexes.METHODS The clinical data were retrospectively collected from 420 cataract patients who received surgical procedures in Shaoxing Central Hospital from De 2020 to Dec 2022.The enrolled patients were divided into the infectious endophthalmitis group with 30 cases and the no infectious endophthalmitis group with 390 cases according to the postoperative status.The species of pathogens were statistically analyzed,the risk factors were analyzed,the levels of serum sTREM-1,HMGB1 and CD64 indexes were compared between the two groups,and the values of the three indexes in diagnosis of the postoperative infectious endophthalmitis were analyzed.RESULTS Among the 420 cataract patients,30(7.14%)were complicated with postoperative infectious endophthalmitis.Totally 34 strains of pathogens were isolated,31(91.18%)of which were gram-positive bacteria.The old age,diabetes mellitus and operation duration(no less than 15 min)were the risk factors for the postoperative infectious endophthalmitis in the cataract patients(P<0.05).The levels of sTREM-1,HMGBl and CD64 indexes of the infectious endophthalmitis group were higher than those of the no infectious endophthalmitis(P<0.05).The area under curve(AUC)of the joint detection of the three indexes was higher than that of the single detection in diagnosis of postoperative infectious endophthalmitis(P<0.05);the sensitivity and specificity were 96.67%and 82.31%,respectively.CONCLUSION The incidence of postoperative infectious endophthalmitis is high among the patients with cataract.The gram-positive bacteria are dominant.The old age,diabetes mellitus and operation duration(no less than 15 min)are the risk factors for the postoperative infectious endophthalmitis.The cataract patients with postoperative infectious endophthalmitis show the rise of sTREM-1,HMGB1 and CD64 indexes.The joint detection of the three indexes has high diagnostic value.