白内障超声乳化吸除术与摘除术患者术后眼内感染及细胞因子IGF-1与bFGF和相关白细胞介素的变化研究  

Prevalence of postoperative endophthalmitis in cataract phacoemulsification and excision patients and changes of cytokines IGF-1,bFGF and related interleukins

作　　者：李锐[1] 袁慧敏[1] 刘钊臣[1] 李勇[1] 岳章显 LI Rui;YUAN Hui-min(Xiaogan Hospital Affiliated to Xiaogan, IU Zhao-chen, LI Yong, YUE Zhang-xian Wuhan University of Science and Technology, Hubei 432000, Chin)

机构地区：[1]武汉科技大学附属孝感医院眼科,湖北孝感432000

出　　处：《中华医院感染学杂志》2018年第10期1529-1532,共4页Chinese Journal of Nosocomiology

基　　金：湖北省自然科学基金资助项目(2015CFF329)

摘　　要：目的探讨白内障超声乳化吸除术与摘除术患者术后眼内感染情况,分析患者细胞因子类胰岛素一号增长因子(IGF-1)、碱性纤维母细胞生长因子(bFGF)及相关白细胞介素的变化情况。方法选取2010年12月-2016年10月医院收治的白内障超声乳化吸除术与摘除术患者12 676例为研究对象,对患者术后眼内感染情况、影响因素等进行分析,观察比较患者感染前后的细胞因子IGF-1、bFGF及相关白细胞介素指标。结果 12 676例白内障手术患者中有61例患者发生术后眼内感染,感染率为0.48%;61例感染患者共检出43株病原菌,其中革兰阳性菌26株占60.47%、革兰阴性菌7株占16.28%及真菌10株占23.26%;多因素Logistic分析结果显示,年龄≥65岁、透明角膜手术切口、手术时间≥10min、存在玻璃体溢出、合并糖尿病为白内障手术患者术后眼内感染的影响因素(P<0.05);感染前患者细胞因子IGF-1、bFGF指标水平高于感染后;感染前患者的血清炎症因子指标表达水平均低于感染后的检测水平(P<0.05)。结论患者术后眼内感染病原菌以革兰阳性菌为主,针对临床影响因素给予早期积极地预防干预,并对相关炎症指标进行观测以指导临床的感染预防。OBJECTIVE To investigate the prevalence of postoperative endophthalmitis infections in cataract phacoemulsification and excision patients and observe the changes of cytokines insulin-like growth factor-1（IGF-1）,basic fibroblast growth factor（bFGF）and related interleukins.METHODS A total of 12 676 patients who underwent the cataract phacoemulsification and excision in the hospital from Dec 2010 to Oct 2016 were recruited as the study objects,the aqueous humor samples were collected from the patients during the surgery so as to conduct culture of pathogens,the prevalence of postoperative intraocular infections and influencing factors were analyzed,and the cytokines IGF-1,bFGF and related interleukins of the patients were observed and compared before and after the infection.RESULTS Of the 12 676 cataract surgery patients,61 has postoperative intraocular infections,with the infection rate 0.48%.Totally 43 strains of pathogens were isolated from the 61 patients with infections,26（60.47%）of which were gram-positive bacteria,7（16.28%）were gram-negative bacteria,and 10（23.26%）were fungi.The result of multivariate logistic analysis showed that the no less than 65 years of age,transparent corneal incision,operation duration no less than 10 min,vitreous overflow and complication with diabetes mellitus were the influencing factors for the postoperative intraocular infections in the cataract surgery patients（P〈0.05）.The levels of cytokines IGF-1 and bFGF of the patients were higher before the infection than after the infection;the levels of expression of serum inflammatory factors of the patients were significantly lower before the infection than after the infection（P〈0.05）.CONCLUSION The gram-positive bacteria are dominant among the pathogens causing the postoperative intraocular infections.It is necessary to take prevention interventions according to the influencing factors in early stage and monitor the related inflammatory indexes so as to provide guidance for clinical prevention of the inf

关 键 词：白内障 超声乳化吸除术 摘除术 眼内炎 感染 细胞因子 白细胞介素 

分 类 号：R619[医药卫生—外科学]