白内障术后感染性眼内炎病原学与危险因素及PCT、CD64、bFGF mRNA的预测价值

Etiological characteristics and risk factors for postoperative endophthalmitis in cataract patients and predictive values of PCT, CD64 and bFGF mRNA

    摘要
  • 摘要: 目的 分析白内障术后感染性眼内炎的病原学特点、危险因素及降钙素原(PCT)、CD64、碱性成纤维细胞生长因子(bFGF)mRNA的预测价值。方法 回顾性纳入2020年1月-2023年1月于武汉爱尔眼科汉阳医院治疗的白内障术后非感染性眼内炎患者497例为非感染性眼内炎组,转诊至医院的白内障术后感染性眼内炎患者25例为感染性眼内炎组。分析白内障术后感染性眼内炎的病原学特点,通过单因素、多因素分析白内障术后感染性眼内炎的危险因素。比较两组PCT、CD64、bFGF mRNA水平,绘制受试者工作特征(ROC)曲线分析PCT、CD64、bFGF mRNA单独及联合检测对白内障术后感染性眼内炎的预测价值。结果 25例白内障术后感染性眼内炎患者共分离病原菌31株,共分离病原菌31株,以革兰阳性菌为主,占比48.39%; 多因素Logistic分析结果显示,手术时间≥30 min、晶状体类型为聚甲基丙烯酸甲酯为白内障术后感染性眼内炎的危险因素(P＜0.05); 感染性眼内炎组血清PCT水平、全血CD64水平、泪液bFGF mRNA水平较非感染性眼内炎组更高(P＜0.05); PCT、CD64、bFGF mRNA联合检测曲线下面积(AUC)为0.932,敏感性为92.00%,特异性为90.14%,均高于单独检测。结论 白内障术后感染性眼内炎的病原学以革兰阳性菌为主,分析危险因素可为预防措施的制定提供依据,联合检测PCT、CD64、bFGF mRNA有助于白内障术后感染性眼内炎的诊断。

     

    Abstract: OBJECTIVE To analyze the etiology, high risk factors and the predictive value of procalcitonin (PCT), CD64 and basic fibroblast growth factor (bFGF) mRNA in patients with infectious endophthalmitis after cataract surgery. METHODS Totally 497 cataract patients without postoperative infectious endophthalmitis who were treated in Wuhan Aier Eye Hanyang Hospital from Jan 2020 to Jan 2023 were retrospectively enrolled in the study and assigned as the non-infectious endophthalmitis group, and 25 cataract patients with postoperative infectious endophthalmitis who were transferred to the hospital were chosen as the infectious endophthalmitis group. The etiology of infectious endophthalmitis after cataract surgery was analyzed, and the high risk factors for infectious endophthalmitis after cataract surgery were analyzed by univariate and multivariate analysis. The mRNA levels of PCT, CD64 and bFGF were compared between the two groups, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of PCT, CD64 and bFGF mRNA individual and combined for infectious endophthalmitis. RESULTS A total of 31 strains of pathogens were isolated from the 25 cataract patients with postoperative endophthalmitis, mainly gram-positive bacteria, accounting for 48.39%. Multivariate logistic analysis showed that operation time ≥30 min, polymethyl methacrylate lens type were risk factors for infectious endophthalmitis after cataract surgery (P＜0.05). The levels of serum PCT, whole blood CD64 and tear bFGF mRNA in the infectious endophthalmitis group were higher than those in the non-infectious endophthalmitis group (P＜0.05). The area under the curve (AUC) of combined detection of PCT, CD64 and bFGF mRNA was 0.932, with the sensitivity of 92.00%, and the specificity of 90.14%, which were higher than those of single detection. CONCLUSION The mian pathogen of infectious endophthalmitis after cataract surgery was gram-positive bacteria. Risk factors analysis can provide a basis for the formulation of preventive measures. The combined detection of PCT, CD64 and bFGF mRNA was helpful for the diagnosis of infectious endophthalmitis after cataract surgery.

     

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