目的：探讨血清中髓系细胞表达触发受体-1(TREM-1)、基质金属蛋白酶-9(MMP-9)表达水平变化对白内障术后眼内炎患者早期临床诊断的价值。

方法：选取2021-05/2023-05在我院进行白内障手术并发生感染性眼内炎患者21例作为研究对象(眼内炎组)，另选取进行白内障手术未发生眼内炎患者100例作为非眼内炎组。检测并比较眼内炎组和非眼内炎组血清TREM-1、MMP-9水平以及IL-1β、IL-17、TNF-α等炎症因子表达水平，采用Pearson法分析TREM-1与MMP-9相关性，采用Logistic回归分析影响白内障患者术后出现眼内炎的因素。基于受试者工作特征(ROC)曲线分析TREM-1、MMP-9水平对白内障患者术后眼内炎的早期临床诊断效能。

结果：与白内障术后非眼内炎组相比，眼内炎组血清TREM-1、MMP-9和炎症因子IL-1β、IL-17、TNF-α表达水平均显著升高(均P<0.05)。TREM-1与MMP-9呈正相关(r=0.389，P<0.001)。Logistic回归结果显示，血清TREM-1及MMP-9表达水平升高、有玻璃体溢出均是导致白内障患者术后发生眼内炎的危险因素(均P<0.05)。ROC曲线显示TREM-1、MMP-9和二者联合诊断白内障患者术后眼内炎的曲线下面积(AUC)分别为0.845、0.844、0.935，二者联合应用早期诊断白内障患者术后出现眼内炎的临床效能优于血清TREM-1、MMP-9单独预测(均P<0.05)。

结论：白内障术后眼内炎患者血清TREM-1、MMP-9表达水平异常升高，且联合二者早期诊断白内障术后眼内炎的临床应用价值较高。

METHODS: A total of 21 patients who underwent cataract surgery with infectious endophthalmitis in our hospital from May 2021 to May 2023 were selected as the study subjects(endophthalmitis group), and another 100 patients who underwent cataract surgery without endophthalmitis were selected as the non-endophthalmitis group. The serum levels of TREM-1, MMP-9, and the expression levels of inflammatory factors such as interleukin-1β(IL-1β), IL-17, and tumor necrosis factors-α(TNF-α)were detected and compared between the endophthalmitis group and the non-endophthalmitis group. The correlation between TREM-1 and MMP-9 was analyzed by Pearson method. Logistic regression was applied to analyze the factors that affected the occurrence of endophthalmitis in cataract patients after surgery. Receiver operating characteristic(ROC)curve was applied to analyze the early clinical diagnostic efficacy of TREM-1 and MMP-9 levels for postoperative endophthalmitis in cataract patients.

RESULTS: Compared with the non-endophthalmitis group after cataract surgery, the expression levels of serum TREM-1, MMP-9, and inflammatory factors IL-1β, IL-17, and TNF-α in the endophthalmitis group were obviously increased(all P<0.05), and the TREM-1 was positively correlated with MMP-9(r=0.389, P<0.001). Logistic regression results showed that elevated levels of serum TREM-1 and MMP-9 expression, and vitreous overflow were independent risk factors for postoperative endophthalmitis in cataract patients(all P<0.05). ROC curve showed that the area under the curve(AUC)of TREM-1, MMP-9, and their combination in diagnosing postoperative endophthalmitis in cataract patients was 0.845, 0.844, and 0.935, respectively, and the clinical efficacy of the combination of the two in early diagnosis of postoperative endophthalmitis in cataract patients was better than that of serum TREM-1 and MMP-9 alone(all P<0.05).

CONCLUSION: The expression levels of serum TREM-1 and MMP-9 in patients with endophthalmitis after cataract surgery are abnormally elevated, and the combination of the two has high clinical application value in early diagnosis of endophthalmitis after cataract surgery.