玻璃体视网膜术后感染病原菌特点及血清和玻璃体IGF-1与VEGF表达意义  

Characteristics of pathogenic bacteria after vitreoretinal surgery and the expression significance of IGF-1 and VEGF in serum and vitreous body

作　　者：潘雪峰[1] 翁明 刘云芳[1] 胡勇平[2] 董枫 PAN Xue-feng;WENG Ming;LIU Yun-fang;HU Yong-ping;DONG Feng(Huzhou First People＇s Hospital, Zhejiang Province, Huzhou ,Zhejiang 313000, China)

机构地区：[1]湖州市第一人民医院眼科,浙江湖州313000 [2]杭州市第一人民医院眼科,浙江杭州310006 [3]浙江大学医学院附属第一医院眼科,浙江杭州310008

出　　处：《中华医院感染学杂志》2018年第7期1064-1067,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生基金资助项目(2014KYA058)

摘　　要：目的探讨玻璃体视网膜术后感染病原菌特点及血清和玻璃体胰岛素生长因子(IGF-1)和血管内皮生长因子(VEGF)的表达意义。方法选择于2013年6月-2017年6月医院收治的行玻璃体视网膜手术患者3 971例。分别采集患者血清标本和玻璃体液标本,采用酶联免疫吸附法测定IGF-1和VEGF含量;同时采集患者玻璃体液标本分离培养及细菌鉴定,进行耐药性试验。结果 3 971例患者中有21例玻璃体视网膜手术术后发生感染性眼内炎,感染率为0.53%;21例术后感染性眼内炎患者中共分离培养病原菌19株,其中革兰阳性菌15株占78.95%、革兰阴性菌2株占10.53%、真菌2株占10.53%;表皮葡萄球菌对左氧氟沙星、红霉素、青霉素G和头孢他啶耐药率较高,均>70%;感染组患者血清IGF-1和VEGF水平高于未感染组(P<0.05);感染组患者玻璃体中IGF-1和VEGF水平高于未感染组(P<0.05)。结论玻璃体视网膜术后感染病原菌主要为表皮葡萄球菌,术后感染患者血清和玻璃体中IGF-1和VEGF水平升高,提示可能参与玻璃体视网膜手术患者术后感染性眼内炎发生和发展。OBJECTIVE To investigate the characteristics of pathogens and the expression significance of insulin growth factor（IGF-1）and vascular endothelial growth factor（VEGF）in serum and vitreous after vitreoretinal surgery.METHODS A total of 3971 patients with vitreoretinal surgery from Jun.2013 to Jun.2017 in our hospital were selected.Serum samples and vitreous fluid samples were collected.Enzyme linked immunosorbent assay（ELISA）was used to determine the contents of IGF-1 and VEGF.At the same time,specimens of vitreous fluid collected from patients were used for isolation,culture,bacterial identification,and drug resistance test.RESULTS Totally 21 cases of infective endophthalmitis occurred after vitreoretinal surgery among 3971 patients,and the infection rate was 0.53%.Among the 21 cases of postoperative endophthalmitis,19 strains of pathogens were isolated,including 15 strains of gram-positive bacteria accounting for 78.95%,2 strains of gram-negative bacteria accounting for 10.53%,and 2 strains of fungi accounting for 10.53%.The resistant rates of Staphylococcus epidermidis to levofloxacin,erythromycin,penicillin G,and ceftazidime were high,which were all higher than 70%.The serum IGF-1 and VEGF levels in infected group were higher than those in uninfected group（P〈0.05）.The levels of IGF-1 and VEGF in vitreous body of infected group were significantly higher than those of uninfected group（P〈0.05）.CONCLUSION The main pathogens of infection after vitreoretinal surgery are Staphylococcus epidermidis,and the levels of IGF-1 and VEGF in serum and vitreous increase after operation.It may be involved in the occurrence and development of infectious endophthalmitis after vitreoretinal surgery.

关 键 词：玻璃体视网膜 术后感染 病原菌 胰岛素生长因子 血管内皮生长因子 

分 类 号：R619.3[医药卫生—外科学]