白内障超声乳化术后感染性眼内炎的炎症指标变化及危险因素分析  

Changes in inflammatory indexes and risk factors of infective endophthalmitis after phacoemulsification of cataract

作　　者：赵荣超[1] 郭长城 赵松伟 ZHAO Rong-chao;GUO Chang-cheng;ZHAO Song-wei(Department of Clinical Laboratory,the Second People's Hospital of Zhengzhou,Zhengzhou 450000,Henan,CHINA;Department of Clinical Laboratory,Yellow River Central Hospital,Yellow River Conservancy Commission,Zhengzhou 450003,Henan,CHINA;Teaching Office of Nursing School,Hebi Vocational and Technical College,Hebi 458030,Henan,CHINA)

机构地区：[1]郑州市第二人民医院检验科,河南郑州450000 [2]黄河水利委员会黄河中心医院检验科,河南郑州450003 [3]鹤壁职业技术学院护理学院教学办,河南鹤壁458030

出　　处：《海南医学》2024年第19期2783-2786,共4页Hainan Medical Journal

基　　金：河南省医学科技攻关计划项目(编号:2018020884)。

摘　　要：目的探讨白内障患者超声乳化术后感染性眼内炎的炎症指标变化及其危险因素。方法选择2022年1月至2023年12月郑州市第二人民医院收治的126例白内障超声乳化手术患者作为观察组,将20例术后发生感染性眼内炎者作为感染组,106例未发生感染性眼内炎者作为未感染组,选取同期在本院体检的100例健康人群作为对照组。术后第3天清晨,比较两组受检者血清高敏C反应蛋白(hs-CRP)、血清淀粉样蛋白A(SAA)、降钙素原(PCT)、白细胞介素-1β(IL-1β)水平,并比较感染组和未感染组患者的一般临床资料(年龄、性别、吸烟、饮酒、糖尿病、高血压)、术中情况(手术切口位置、手术时间、术中出血量)和血清hs-CRP、SAA、PCT、IL-1β水平。采用Logistic回归分析影响白内障超声乳化术后感染性眼内炎的危险因素。结果观察组患者的血清hs-CRP、SAA、PCT、IL-1β水平分别为(21.49±3.01)mg/L、(15.28±2.63)mg/L、(2.12±0.80)ng/L、(23.11±5.70)ng/L,明显高于对照组的(6.15±1.20)mg/L、(6.45±1.09)mg/L、(0.40±0.05)ng/L、(17.10±4.19)ng/L,差异均有统计学意义(P<0.05);感染组患者的术中出血量、血清hs-CRP、SAA、PCT、IL-1β分别为(123.25±36.35)m L、(32.45±5.13)mg/L、(23.01±4.25)mg/L、(6.79±1.45)ng/L、(36.42±6.40)ng/L,明显高于未感染组的(108.26±22.78)m L、(10.25±1.85)mg/L、(13.43±2.54)mg/L、(0.70±0.17)ng/L、(20.93±4.35)ng/L,差异均有统计学意义(P<0.05);Logistic回归分析结果显示,术中出血量、血清hs-CRP、SAA、PCT、IL-1β均是影响白内障超声乳化术后感染性眼内炎的危险因素(P<0.05)。结论白内障超声乳化术后感染性眼内炎患者的血清hs-CRP、SAA、PCT、IL-1β水平均明显升高,且其与术中出血量均是术后眼内炎感染的危险因素,针对各危险因素制定干预措施,有助于减少感染性眼内炎发生。Objective To investigate the changes of inflammatory indexes and and analyze the risk factors of infective endophthalmitis after phacoemulsification of cataract.Methods A total of 126 cataract patients undergoing phacoemulsification who were admitted to the Second People's Hospital of Zhengzhou from January 2022 to December 2023 were selected as the observation group,of which 20 with postoperative infectious endophthalmitis were selected as the infected subgroup and 106 without postoperative infectious endophthalmitis were selected as the non-infected subgroup.One hundred healthy people in the hospital were selected as the control group during the same period.On the morning of the third day after surgery,the levels of serum high-sensitivity C-reactive protein(hs-CRP),serum amyloid A(SAA),procalcitonin(PCT),and interleukin-1β(IL-1β)were compared between the observation group and the control group.The general clinical data(age,sex,smoking,drinking,diabetes,hypertension),intraoperative conditions(incision position,operation time,intraoperative bleeding volume),and serum hs-CRP,SAA,PCT,IL-1βlevels were compared between the infected subgroup and the uninfected subgroup.Logistic regression was used to analyze the risk factors of infective endophthalmitis after phacoemulsification.Results The serum hs-CRP,SAA,PCT,and IL-1βlevels in the observation group were(21.49±3.01)mg/L,(15.28±2.63)mg/L,(2.12±0.80)ng/L,and(23.11±5.70)ng/L,which were significantly higher than(6.15±1.20)mg/L,(6.45±1.09)mg/L,(0.40±0.05)ng/L,and(17.10±4.19)ng/L in the control group(P<0.05).The intraoperative bleeding,serum hs-CRP,SAA,PCT,and IL-1βin the infected subgroup were(123.25±36.35)mL,(32.45±5.13)mg/L,(23.01±4.25)mg/L,(6.79±1.45)ng/L,and(36.42±6.40)ng/L,which were significantly higher than(108.26±22.78)mL,(10.25±1.85)mg/L,(13.43±2.54)mg/L,(0.70±0.17)ng/L,and(20.93±4.35)ng/L in the uninfected subgroup(P<0.05).Logistic regression analysis showed that intraoperative hemorrhage,serum hs-CRP,SAA,PCT,and IL-1βwere risk factors f

关 键 词：白内障超声乳化术 感染性眼内炎 超敏C-反应蛋白 淀粉样蛋白A 降钙素原 白介素-1Β 危险因素 

分 类 号：R776.1[医药卫生—眼科]