目的：了解中国华南地区眼科患者近年术前四项指标的感染状况及阳性患者在不同眼病中的分布。方法：回顾性分析2017年1月~2023年12月在中山大学中山眼科中心进行乙型肝炎表面抗原(HBsAg)、丙肝肝炎病毒抗体(抗-HCV)、梅毒螺旋体抗体(抗-TP)、人类免疫缺陷病毒抗体(抗-HIV)指标筛查的门诊、手术和(或)住院患者资料，并记录和分析患者各项指标的阳性情况。结果：共纳入253 246例患者，HBsAg、抗-HCV、抗-TP和抗-HIV阳性率分别是9.00%、0.45%、1.55%、0.13%。两种或两种以上感染指标阳性的患者共有686例， HBsAg和抗HCV同时阳性的例数最高(57.29%)，其次为抗-HIV和抗-TP(15.74%)。2017~2023年HBsAg阳性率逐年递减，而抗-HCV、抗-HIV、抗-TP阳性率变化不明显。男性的HBsAg、抗-HCV、抗-TP、抗-HIV阳性率均高于女性，差异均有统计学意义(P <0.001)。HBsAg、抗-HCV、抗-TP、抗-HIV阳性率在不同年龄段比较差异均有统计学意义(P <0.001)。在HBsAg、抗-HCV、抗-TP阳性患者中，晶状体病的病例数占比最高，分别为36.72%、39.12%、46.97%。其次是玻璃体/视网膜疾病，占比分别为22.52%、19.65%、19.69%。在抗-HIV阳性患者中，玻璃体/视网膜疾病的病例数占比最高，为42.99%，其次是晶状体病，占26.17%，葡萄膜炎占8.72%。结论：本研究揭示了眼科患者术前四项指标的感染情况及感染患者在不同眼病中的分布，这对于评估眼科手术风险、制定感染控制措施具有重要意义。

Objective: To understand the infection status of four blood-borne pathogens among ophthalmology patients in South China and the distribution of positive patients across different eye diseases. Methods: A retrospective analysis of data from outpatient and inpatient or surgical ophthalmic patients who underwent screening for hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (anti-HCV), treponema pallidum antibody (anti-TP) and human immunodeficiency virus antibody (anti-HIV) at Zhongshan Ophthalmic Center of Sun Yat-sen University from January 2017 to December 2023. The positivity rates of these markers were recorded and analyzed. Results: A total of 253246 patients were included in the study, with positivity rates for HBsAg, anti-HCV, anti-TP, and anti-HIV at 9.00%, 0.45%, 1.55% and 0.13%, respectively. Among these, 686 patients tested positive for two or more markers, with the highest co-positivity observed for HBsAg and anti-HCV (57.29%), followed by anti-HIV and anti-TP (15.74%). The positivity rate of HBsAg showed a yearly decline, while the rates for anti-HCV, anti-HIV, and anti-TP remained relatively stable from 2017 to 2023. Males had significantly higher positivity rates for HBsAg, anti-HCV, anti-TP, and anti-HIV compared to females (P < 0.001). Significant differences in positivity rates for these markers were also observed across different age groups (P < 0.001). In patients with positive HBsAg, anti-HCV, and anti-TP, the proportion of cases with lens diseases were the highest, at 36.72%, 39.12%, and 46.97%, respectively. Vitreoretinal diseases followed, with proportions of 22.52%, 19.65%, and 19.69%, respectively. Among patients with positive anti-HIV, the proportion of cases with vitreoretinal diseases was the highest, at 42.99%, followed by lens diseases at 26.17%, and uveitis at 8.72%. Conclusions: This study reveals the infection status of four blood-borne pathogens in ophthalmology patients and the distribution of infected patients across different eye diseases, which is significant for assessing the risks of ophthalmic surgery and formulating infection control measures.