左氧氟沙星滴眼液对睑板腺功能障碍合并白内障手术患者眼表菌群组成的影响  

Effect of levofloxacin eye drops on composition of ocular surface flora in meibomian gland dysfunction patients complicated with cataract

作　　者：刘娴[1] 曾明范 张妮红 LIUXian;ZENG Ming-fan;ZHANG Ni-hong(First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan 473058,China)

机构地区：[1]南阳医学高等专科学校第一附属医院眼科二病区,河南南阳473058

出　　处：《中华医院感染学杂志》2024年第6期877-881,共5页Chinese Journal of Nosocomiology

基　　金：河南省卫生健康委员会基金资助项目(2023ZY2187)。

摘　　要：目的 评估使用5%左氧氟沙星滴眼液对睑板腺功能障碍合并白内障手术患者眼表细菌群落组成及多样性的影响。方法 选择2021年4月—2022年10月在南阳医学高等专科学校第一附属医院眼科接受睑板腺功能障碍合并白内障手术的180例患者为研究对象,从手术前3 d开始,每天向待手术眼滴注4次5%左氧氟沙星滴眼液,用药前和用药后,双眼结膜拭子采样,通过16S rRNA基因测序,比较用药前后眼表细菌群落多样性和分类学差异。结果 本研究最终纳入63例(100眼)患者,共获得94份样本,534 664条有效序列及941个OTUs,使用5%左氧氟沙星滴眼液后,眼表微生物OTUs数量较用药前减少;Alpha和Beta多样性分析结果显示,用药后与用药前微生物群落无统计学差异;物种分类组成分析显示,用药前与用药后核心关键微生物具有统计学差异(P<0.05)。结论 睑板腺功能障碍合并白内障手术患者眼表细菌菌群多样性丰富,5%左氧氟沙星滴眼液可改变眼表细菌群落,而不改变眼内的生理微生物组成。白内障手术前使用5%左氧氟沙星滴眼液作为安全和选择性的治疗,可能有利于改善眼表生理防御和控制细菌性眼表污染。OBJECTIVE To assess the effect of 5%levofloxacin eye drops on composition and diversity of ocular surface flora in meibomian gland dysfunction patients complicated with cataract.METHODS A total of 180 meibo-mian gland dysfunction patients complicated with cataract who received surgical procedures in the First Affiliated Hospital of Nanyang Medical College from Apr 2021 to Oct 2022 were recruited as the study subjects.The eyes were treated with 5%levofloxacin eye drops 4 times a day starting from 3 days before the surgery,conjunctival swab specimens of both eyes were collected before and after the medication,16S rRNA gene sequencing was car-ried out,and the diversity and taxonomic differences among the ocular surface flora were observed and compared before and after the medication.RESULTS Totally 63 patients(100 eyes)were finally included in the study.A to-tal of 94 samples,534664 effective sequences and 941 OTUs were acquired.The OTUs of ocular surface microor-ganisms were less after the use of 5%levofloxacin eye drops than before the medication.The results of Alpha and Beta diversity analysis showed that there was no significant difference in the microflora before and after the medi-cation.The taxonomic composition analysis of species indicated that there was significant difference in the core and key microorganisms before and after the medication.CONCLUSION The meibomian gland dysfunction patients complicated with cataract show diversified species of ocular surface flora,the 5%levofloxacin eye drops may alter the ocular surface flora and not alter the composition of ocular physiological microorganisms.The 5%levofloxacin eye drops can be used for safe and selective treatment before the surgery for cataract,which may improve physio-logical defense and control the contamination of bacterial ocular surface.

关 键 词：眼表微生物群 睑板腺功能障碍 白内障手术 16S rRNA基因扩增子测序 左氧氟沙星滴眼液 

分 类 号：R777.1[医药卫生—眼科]