摘要
目的探究血清缺氧诱导因子1α(HIF-1α)、血管内皮生长因子(VEGF)、可溶性髓系细胞触发受体1(sTREM-1)及炎症因子与肛瘘术后切口感染的相关性。方法回顾性分析2022年6月至2023年4月在成都市双流区第一人民医院行肛瘘挂线术治疗的120例患者的临床资料,根据患者术后切口感染状况将其分为感染组(36例)与非感染组(84例),比较感染组与未感染组血清HIF-1α、VEGF、sTREM-1及炎症因子[C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平的差异,通过Pearson相关系数分析CRP、IL-6、TNF-α、HIF-1α、VEGF、sTREM-1与肛瘘术后感染发生的相关性;CRP、IL-6、TNF-α与HIF-1α、VEGF、sTREM-1的相关性。并经受试者工作特征(ROC)曲线分析血清HIF-1α、VEGF、sTREM-1、炎症因子单独及联合诊断肛瘘术后切口感染的效能。结果感染组术后3 d的血清HIF-1α、sTREM-1、CRP、IL-6、TNF-α水平均高于术前,且高于未感染组;VEGF低于术前,且低于未感染组(均P<0.05)。Pearson相关分析显示,HIF-1α、sTREM-1、CRP、IL-6、TNF-α与肛瘘术后感染发生呈正相关(r=0.456、0.494、0.455、0.510、0.363,均P<0.05),VEGF与肛瘘术后感染发生呈负相关(r=-0.462,P<0.05);CRP、IL-6、TNF-α与HIF-1α、sTREM-1均呈正相关(r=0.574/0.611/0.653、0.661/0.608/0.610,均P<0.05),CRP、IL-6、TNF-α与VEGF呈负相关(r=-0.200、-0.207、-0.254,均P<0.05)。HIF-1α、VEGF、sTREM-1、CRP、IL-6、TNF-α诊断肛瘘术后切口感染的曲线下面积(AUC)分别为0.716、0.787、0.741、0.678、0.792、0.688。炎症因子联合、6个数据联合诊断肛瘘术后切口感染的AUC分别为0.836、0.921。结论肛瘘术后切口感染患者血清HIF-1α、sTREM-1、CRP、IL-6、TNF-α存在异常高表达,VEGF存在异常低表达,HIF-1α、VEGF、sTREM-1与炎症因子可作为临床诊断肛瘘术后切口感染的有效指标,联合诊断价值更好,且HIF-1α、sTREM-1与炎症因子存在正相关,VEGF与炎症因子�
ObjectiveTo investigate the correlation between serum hypoxia inducible factor 1 alpha(HIF-1α),vascular endothelial growth factor(VEGF),soluble triggering receptor expressed on myeloid cells-1(sTREM-1),and inflammatory factors and incision infection after anal fistula surgery.MethodsA retrospective analysis was conducted on the clinical data of 120 patients who underwent anal fistula thread hanging surgery at the First People′s Hospital of Shuangliu District,Chengdu from June 2022 to April 2023.The patients were divided into an infected group(36 cases)and a non infected group(84 cases)based on their postoperative incision infection status.The differences in serum HIF-1α,VEGF,sTREM-1 and inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factorα(TNF-α)]between the infected and non infected groups were compared,and the correlation between CRP,IL-6,TNF-α,HIF-1α,VEGF,sTREM-1 and postoperative infection of anal fistula was analyzed by Pearson correlation coefficient;The correlation between CRP,IL-6,TNF-αand HIF-1α,VEGF,sTREM-1.And the efficacy of serum HIF-1α,VEGF,sTREM-1,inflammatory factors and their individual and combined diagnosis of incision infection after anal fistula surgery was analyzed by receiver operating characteristic(ROC)curve analysis.ResultsThe levels of serum HIF-1α,sTREM-1,CRP,IL-6,and TNF-αin the infected group were higher than those before surgery and higher than those in the uninfected group 3 days after surgery;VEGF levels were lower than preoperative levels and lower than those in the non infected group(all P<0.05).Pearson correlation analysis showed that HIF-1α,sTREM-1,CRP,IL-6,TNF-αwere positively correlated with postoperative infection in anal fistula(r=0.456,0.494,0.455,0.510,0.363,all P<0.05),while VEGF was negatively correlated with postoperative infection in anal fistula(r=-0.462,P<0.05).CRP,IL-6,TNF-αwere positively correlated with HIF-1αand sTREM-1(r=0.574/0.611/0.653,0.661/0.608/0.610,all P<0.05),while CRP,IL-6,TNF-αwere negatively corre
作者
刘勇桃
李扬轶
黄娟
Liu Yongtao;Li Yangyi;Huang Juan(Department of Proctology,The First People′s Hospital of Shuangliu District,West China Airport Hospital of Sichuan University,Chengdu 610200,China)
出处
《中国医师杂志》
CAS
2024年第8期1222-1226,共5页
Journal of Chinese Physician
关键词
外科伤口感染
肛瘘
缺氧诱导因子1
α亚单位
血管内皮生长因子
髓系细胞触发受体1
Surgical wound infection
Anal fistula
Hypoxia-inducible factor 1,alpha subunit
Vascular endothelial growth factors
Triggering receptor expressed on myeloid cells-1
