| 张庆云,吕爱华,李 斌,王建民,袁祥文.白内障患者术后感染性眼内炎的病原菌分布及CD64指数、血清sTREM1、HMGB1表达的临床意义[J].,2023,(18):3572-3576 |
| 白内障患者术后感染性眼内炎的病原菌分布及CD64指数、血清sTREM1、HMGB1表达的临床意义 |
| Distribution of Pathogenic Bacteria and Clinical Significance of CD64 Index, Serum sTREM1 and HMGB1 Expression in Postoperative Infectious Endophthalmitis in Cataract Patients |
| 投稿时间：2023-03-04 修订日期：2023-03-25 |
| DOI：10.13241/j.cnki.pmb.2023.18.034 |
| 中文关键词: 白内障 感染性眼内炎 病原菌 分化簇64指数 可溶性髓系细胞触发受体1 高迁移率族蛋白1 临床意义 |
| 英文关键词: Cataract Infectious endophthalmitis Pathogenic bacteria Cluster of differentiation 64 index Soluble triggering receptor expressed on myeloid cells 1 High mobility group protein 1 Clinical significance |
| 基金项目:山东省科研基金资助项目（Q124110） |
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| 中文摘要: |
| 摘要 目的：分析白内障患者术后感染性眼内炎（IE）的病原菌分布并探讨分化簇64（CD64）指数、血清可溶性髓系细胞触发受体1（sTREM1）、高迁移率族蛋白1（HMGB1）表达的临床意义。方法：选取2018年1月～2022年7月济南市人民医院眼科收治的125例（125眼）白内障术后IE患者为IE组，选取同期150例（150眼）白内障术后无术后IE患者为非IE组。分析术后IE患者病原菌分布，计算CD64指数和检测血清sTREM1、HMGB1表达。采用多因素Logistic回归分析白内障患者术后IE的影响因素，采用受试者工作特征（ROC）曲线分析CD64指数、血清sTREM1、HMGB1表达对白内障患者术后IE的诊断价值。结果：125例术后IE患者房水或玻璃原液中检测出138株病原菌，革兰氏阳性菌、革兰氏阴性菌、真菌分别占比81.88%（113/138）、16.67%（23/138）、1.45%（2/138）。与非IE组比较，IE组糖尿病、玻璃体溢出比例、CD64指数和血清sTREM1、HMGB1水平升高，手术时间更长（P＜0.05）。多因素Logistic回归分析显示，糖尿病、玻璃体溢出、手术时间延长和CD64指数、sTREM1、HMGB1升高为白内障患者术后IE的独立危险因素（P＜0.05）。ROC曲线分析显示，CD64指数与血清sTREM1、HMGB1联合预测白内障患者术后IE的曲线下面积显著高于单独预测。结论：白内障患者术后IE的病原菌以革兰氏阳性菌为主，CD64指数和血清sTREM1、HMGB1表达与白内障患者术后IE独立相关，可能成为白内障患者术后IE的辅助诊断指标，且三指标联合具有较高的预测价值。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the distribution of pathogenic bacteria in postoperative infectious endophthalmitis (IE) in cataract patients and to investigate the clinical significance of the cluster of differentiation 64 (CD64) index, soluble triggering receptor expressed on myeloid cells 1 (sTREM1) and high mobility group protein 1 (HMGB1) expression. Methods: 125 patients (125 eyes) with IE after cataract surgery who were treated in the Ophthalmology department of Jinan People's Hospital from January 2018 to July 2022 were selected as the IE group, and 150 patients (150 eyes) without IE after cataract surgery during the same period were selected as the non-IE group. The distribution of pathogenic bacteria in patients with postoperative IE was analyzed, CD64 index was calculated, and serum sTREM1 and HMGB1 expression were detected. Multivariate Logistic regression was used to analyze the influencing factors of postoperative IE in cataract patients. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of CD64 index, serum sTREM1 and HMGB1 expression in the postoperative IE in cataract patients. Results: 138 strains of pathogenic bacteria were detected in aqueous humor or glass stock solution of 125 patients with postoperative IE, and Gram-positive bacteria, Gram-negative bacteria and fungi accounted for 81.88% (113/138), 16.67% (23/138) and 1.45% (2/138), respectively. Compared with non-IE group, the proportion of diabetes mellitus, vitreous overflow and CD64 index, serum sTREM1 and HMGB1 levels were elevated, and operation time is longer in the IE group(P＜0.05). Multivariate Logistic regression analysis showed that diabetes mellitus, vitreous overflow, prolonged operation time and elevated CD64 index, sTREM1 and HMGB1 were independent risk factors for postoperative IE in cataract patients (P＜0.05). ROC curve analysis showed that CD64 index combined with serum sTREM1 and HMGB1 predicted the area under the curve of postoperative IE in cataract patients significantly higher than that predicted alone. Conclusion: The pathogenic bacteria of postoperative IE in cataract patients are mainly Gram-positive bacteria, and CD64 index, serum sTREM1 and HMGB1 expression are independently correlated with postoperative IE in cataract patients, which may become auxiliary diagnostic indicators of postoperative IE in cataract patients, and the combination of the three indicators has high predictive value. |
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