摘要
目的探讨血清降钙素原(procalcitonin,PCT)检测对于外伤性眼内炎诊断的价值。方法回顾性病例对照研究。收集郑州大学第一附属医院2018年1月至2019年11月初诊的外伤性眼内炎51例(51只眼)为观察组,同期1∶1配对的白内障51例(51只眼)为对照组,对比分析两组PCT、白细胞(WBC)及中性粒细胞(NE)检测的差异性与相关性,绘制受试者工作特征(ROC)曲线评估PCT对外伤性眼内炎诊断的价值,并探究PCT、年龄、性别、就诊前天数等因素与预后的关系。结果PCT与WBC及NE有良好的相关性,观察组的这3项指标均高于对照组(P<0.05)。观察组PCT的中位数为0.045,截断值为0.0305,PCT预测眼内炎的相应灵敏度为82.4%,特异度为92.2%,ROC曲线下面积(AUC)为0.879,95%CI(0.807,0.951),高于WBC和NE的AUC,且三者联合检测对外伤性眼内炎诊断价值更大(AUC=0.966)。Logistic回归显示年龄是患眼不良预后的危险因素,初入院时的PCT值与预后无关。结论PCT对外伤性眼内炎有良好的临床诊断价值,可作为眼内炎诊断和治疗的参考指标。PCT值>0.0305 ng/mL时可考虑全身使用抗生素。
Objective To investigate the value of serum procalcitonin(PCT)detection on the diagnosis of traumatic endophthalmitis.Methods This was a retrospective case-control study.A total of 51 eyes of 51 cases with traumatic endophthalmitis newly diagnosed in the First Affiliated Hospital of Zhengzhou University from Jan.2018 to Nov.2019 were collected as the observation group,and matched 51 eyes of 51 cases with cataract during the same period as the control group.The differences and correlations of PCT,white blood cell count(WBC),and neutrophil count(NE)were compared between the two groups.Receiver operating characteristic(ROC)curve was drawn to evaluate the value of PCT in diagnosing traumatic endophthalmitis.Logistic regression was used to explore the relationship of prognosis with PCT,age,gender and days before treatment.Results PCT had a good correlation with WBC and NE.PCT,WBC and NE in the observation group were higher than those in the control group.And the differences were statistically significant between the two groups(P<0.05).The median PCT of the observation group was 0.045.The cutoff was 0.0305.The sensitivity and specificity in the cutoff were 82.4%and 92.2%respectively.And the area under the ROC curve(AUC)was 0.879,95%CI(0.807,0.951),which was higher than that of WBC and NE.And the combination of these three parameters was more valuable in the diagnosis of traumatic endophthalmitis(AUC=0.966).Logistic regression showed that age was a risk factor for poor prognosis of the eye received complex surgery such as vitrectomy or eye content removal.And PCT at first admission had no correlation with prognosis.Conclusion PCT has good clinical diagnostic value on traumatic endophthalmitis,and it can be recommended as a reference index for diagnosis and treatment of endophthalmitis.When PCT>0.0305 ng/mL,systemic antibiotics may be considered.
作者
刘超凡
祁颖
黄雪桃
Liu Chaofan;Qi Ying;Huang Xuetao(Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China)
出处
《中华眼外伤职业眼病杂志》
2020年第7期491-495,共5页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
血清
眼内炎
眼损伤
白细胞
中性粒细胞
ROC曲线
Serum
Endophthalmitis
Eye injuries
White blood cell,neutrophil
Receiver operating characteristic curve
