开放性眼外伤合并感染性眼内炎患者结膜囊病原菌及房水IL-6、IL-10、VCAM水平变化的临床意义  

Pathogen distribution in conjunctival sac of patients with open eye trauma combined with infectious endophthalmitis and clinical significance of changes in levels of IL-6,IL-10,and VCAM in aqueous humor

作　　者：张晓茜 菅淑惠 陈穗桦 ZHANG Xiaoqian;GUAN Shuhui;CHEN Suihua(Ophthalmology Department of Nanjing Medical University Ophthalmology Hospital,Nanjing 210000,China)

机构地区：[1]南京医科大学眼科医院眼科,江苏南京210000

出　　处：《中国病原生物学杂志》2024年第3期328-332,共5页Journal of Pathogen Biology

摘　　要：目的探究开放性眼外伤(OGI)合并感染性眼内炎患者结膜囊中病原菌分布及房水白细胞介素6(IL-6)、白细胞介素10(IL-10)、血管细胞粘附因子(VCAM)水平变化的临床意义。方法选取2022年9月至2023年9月本院治疗的50例OGI合并感染性眼内炎患者为观察组,选50例同期本院治疗的OGI未合并感染性眼内炎的患者为对照组。比较房水IL-6、IL-10、VCAM水平;Logistic回归分析OGI患者发生感染性眼炎的影响因素;ROC曲线分析房水IL-6、IL-10、VCAM水平对患者发生感染性眼炎的诊断价值。结果观察组眼内异物穿通伤占比明显高于对照组(P<0.05);50例患者共检验出48例病原菌,其中包括41株革兰阳性菌、5株革兰阴性菌和2株真菌;观察组房水IL-6、VCAM水平明显高于对照组(P<0.05),IL-10水平明显低于对照组(P<0.05);房水IL-6、VCAM水平及外伤类型为患者发生感染性眼内炎的独立危险因素(P<0.05),IL-10为独立保护因素(P<0.05);房水IL-6、IL-10、VCAM诊断OGI患者发生感染性眼内炎的AUC分别为0.784、0.838、0.797,三者联合诊断的AUC为0.909,三者联合诊断优于各因子单独诊断(Z_(三者联合-IL-6)=4.971、Z_(三者联合-IL-10)=2.493、Z_(三者联合VCAM)=4.627,P=0.000、0.013、0.000)。结论OGI合并感染性眼内炎患者房水IL-6、VCAM水平上调,IL-10水平下调,且IL-6、VCAM水平及外伤类型为患者发生感染性眼内炎的独立危险因素,IL-10为独立保护因素,三者联合对OGI患者发生感染性眼内炎具有更高的诊断价值。Objective To investigate the distribution of pathogens in the conjunctival sac of patients with open globe injury(OGI)complicated with infectious endophthalmitis and the clinical significance of changes in levels of interleukin-6(IL-6),interleukin-10(IL-10),and vascular cell adhesion factor(VCAM)in aqueous humor.Methods From September 2022 to September 2023,50 patients with OGI complicated with infectious endophthalmitis who were treated in our hospital were regarded as the observation group,and 50 patients without OGI complicated with infectious endophthalmitis who were treated in our hospital were regarded as the control group.The levels of IL-6,IL-10,and VCAM in aqueous humor were compared.Logistic regression was applied to analyze the influencing factors of infectious ophthalmitis in OGI patients.ROC curve was applied to analyze the diagnostic value of aqueous humor IL-6,IL-10,and VCAM levels in patients with infectious ophthalmitis.Results The proportion of intraocular foreign body penetrating injuries in the observation group was greatly higher than that in the control group(P<0.05).A total of 48 strains of pathogenic bacteria were detected in 50 patients,including 41 strains of Gram-positive bacteria,5 strains of Gram-negative bacteria and 2 strains of fungi,the Gram-positive bacteria mainly included Staphylococcus epidermidis(19 strains,39.58%),Corynebacterium macrococcus(13 strains,27.08%).The levels of IL-6(11.71±3.57 g/L vs.8.95±2.26 g/L)and VCAM(51.36±12.62 pg/mL vs.38.95±10.33 pg/mL)in the aqueous humor of the observation group were greatly higher than those of the control group(P<0.05),while the level of IL-10(1.29±0.24 pg/mL vs.1.68±0.47 pg/mL)was greatly lower than that of the control group(P<0.05).The levels of IL-6 and VCAM in aqueous humor,and the type of trauma were independent risk factors for the development of infectious endophthalmitis in patients(P<0.05),while IL-10 was an independent protective factor(P<0.05).The AUC for diagnosing infectious endophthalmitis in OGI patients with aq

关 键 词：开放性眼外伤 感染性眼内炎 病原菌分布 白细胞介素6 白细胞介素10 血管细胞粘附因子 

分 类 号：R779.6[医药卫生—眼科]