目的：研究白内障术后眼内炎患者血清微小RNA-34a-5p(miR-34a-5p)和沉默信息调节因子T1(SIRT1)的表达变化及意义。

方法：选取2020-05/2024-05白内障术后发生眼内炎患者为感染组(20例)，未发生眼内炎患者为对照组(74例)。ELISA法检测血清SIRT1水平； qRT-PCR检测血清miR-34a-5p水平； 采用Pearson法分析miR-34a-5p和SIRT1的相关性； 采用Logistic回归分析白内障术后发生眼内炎的影响因素。绘制受试者工作特征(ROC)曲线分析血清miR-34a-5p和SIRT1水平对白内障术后发生眼内炎的诊断价值。

结果：与对照组相比，感染组患者血清miR-34a-5p水平显著升高(P<0.001)，SIRT1水平显著降低(P<0.001)。相关性分析结果显示miR-34a-5p和SIRT1呈负相关关系(r=-0.421，P<0.001)。Logistic多因素回归分析结果显示，miR-34a-5p是白内障术后眼内炎感染的危险因素(OR=3.532，P<0.05)，SIRT1是白内障术后眼内炎感染的保护因素(OR=0.875，P<0.05)。ROC曲线显示，血清miR-34a-5p和SIRT1二者联合诊断白内障术后发生眼内炎的曲线下面积(AUC)为0.933(95%CI：0.861-0.975)。

结论：白内障术后眼内炎患者血清miR-34a-5p高表达，SIRT1低表达，与白内障术后眼内炎的发生发展密切相关。

METHODS: Patients with endophthalmitis after cataract surgery from May 2020 to May 2024 were selected as infection group(20 cases), and patients without endophthalmitis were selected as control group(74 cases). Serum SIRT1 levels were detected by ELISA; the serum level of serum miR-34a-5p was detected by qRT-PCR; the correlation between miR-34a-5p and SIRT1 was analyzed by Pearson method; Logistic regression was used to analyze the influencing factors of endophthalmitis after cataract operation. Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum miR-34a-5p and SIRT1 levels in postoperative endophthalmitis.

RESULTS: Compared with the control group, the serum level of miR-34a-5p in the infected group was significantly increased(P<0.001), and the serum level of SIRT1 was significantly decreased(P<0.001). Correlation analysis showed that miR-34a-5p was negatively correlated with SIRT1(r=-0.421, P<0.001). Logistic multivariate regression analysis showed that miR-34a-5p was an independent risk factor affecting endophthalmitis infection after cataract surgery(OR=3.532, P<0.05), and SIRT1 was a protective factor affecting endophthalmitis infection after cataract surgery(OR=0.875, P<0.05). The ROC curve showed that the area under curve(AUC)of serum miR-34a-5p combined with SIRT1 in the diagnosis of postoperative endophthalmitis was 0.933(95%CI: 0.861-0.975).

CONCLUSION:Serum levels of miR-34a-5p are highly expressed and SIRT1 is lowly expressed in postoperative endophthalmitis, they are closely related to the occurrence and development of endophthalmitis after cataract surgery.