白内障超声乳化术后并发感染性眼内炎病原菌及bFGF、SAA、IGF-1表达水平

Pathogenic bacteria isolated from phacoemulsification patients complicated with postoperative infectious endophthalmitis and expressions of bFGF,SAA and IGF-1

目的探究白内障超声乳化术后并发感染性眼内炎(IE)病原菌分布及碱性成纤维细胞生长因子(bFGF)、血清淀粉样蛋白A(SAA)、胰岛素样生长因子-1(IGF-1)表达水平。方法选取绍兴市中医院及诸暨市中心医院2020年1月-2023年3月收治的4713例白内障超声乳化手术患者,根据术后是否并发IE分为感染组25例和非感染组4688例,分析感染病原菌分布,比较两组血清bFGF、SAA、IGF-1水平,受试者工作特征(ROC)曲线分析bFGF、SAA、IGF-1表达对白内障超声乳化手术患者术后并发IE的诊断价值。结果4713例白内障患者超声乳化术后并发IE 25例,IE发生率为0.53%,共检出病原菌25株,以革兰阳性菌为主(21株,占比84.00%);感染组SAA水平高于非感染组(P<0.05);bFGF、IGF-1水平低于非感染组(P<0.05);bFGF、SAA、IGF-1联合对白内障超声乳化手术患者术后并发IE的诊断价值更高,曲线下面积(AUC)值为0.938,敏感度为92.00%,特异度为86.39%。结论白内障超声乳化手术患者术后并发IE发生率高,且病原菌以革兰阳性菌为主,血清SAA水平呈高表达,bFGF、IGF-1水平呈低表达,三者联合检测可提高白内障超声乳化手术患者术后并发IE的诊断价值。

OBJECTIVE To explore the distribution of pathogenic bacteria isolated from the phacoemulsification patients complicated with postoperative infectious endophthalmitis(IE)and analyze the expression levels of basic fibroblast growth factor(bFGF),serum amyloid A(SAA)and insulin-like growth factor-1(IGF-1).METHODS A total of 4713 patients who underwent the phacoemulsification in Shaoxing Traditional Chinese Medicine Hospital and Zhuji Central Hospital from Jan 2020 to Mar 2023 were enrolled in the study and were divided into the infection group with 25 cases and the non-infection group with 4688 cases according to the status of postoperative IE.The distribution of the pathogens causing the infection,the levels of serum bFGF,SAA and IGF-1 were compared between the two groups,and the values of bFGF,SAA and IGF-1 in diagnosis of postoperative IE in the phacoemulsification patients were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Among the 4713 cataract patients undergoing phacoemulsification,25 were complicated with postoperative IE,with the incidence of IE 0.53%.Totally 25 strains of pathogens were isolated,21(84.00%)were gram-positive bacteria.The SAA level of the infection group was significantly higher than that of the non-infection group(P<0.05),the levels of bFGF and IGF-1 of the infection group were significantly lower than those of the non-infection group(P<0.05).The area under curve(AUC)of the joint detection of bFGF,SAA and IGF-1 was 0.938 in diagnosis of postoperative IE in the phacoemulsification patients,with the sensitivity 92.00%,the specificity 86.39%.CONCLUSION The incidence of postoperative IE is high among the phacoemulsification patients,the gram-positive bacteria are dominant among the pathogens,the patients show the high expression of serum SAA and low expressions of bFGF and IGF-1,and the joint detection of the three indexes may raise the diagnostic value of postoperative IE in the phacoemulsification patients.