摘要
目的:探讨血清可溶性髓系细胞触发受体1(sTREM-1)、可溶性细胞间黏附分子-1(s ICAM-1)、联合血清基质金属蛋白酶-3(MMP-3)、C-反应蛋白(CRP)对肛瘘镜下手术治疗肛瘘患者切口感染的预测效果。方法:选取秦皇岛市第一医院2019年1月至2020年6月收治的肛瘘镜下行手术治疗肛瘘的患者104例,采用酶联免疫法检测术前、术后24 h、术后3 d血清sTREM-1、sICAM-1、CRP及MMP-3水平。根据患者术后是否发生切口感染分为感染组与非感染组,采用ROC曲线分析上述指标对术后切口感染的预测评估作用。结果:16例患者出现术后切口感染,发生率为15.4%,88例患者术后未出现切口感染,占84.6%。感染组术后24 h及3 d血清sTREM-1、sICAM-1、CRP及MMP-3水平均高于术前(P<0.05),且术后24 h血清sTREM-1、sICAM-1、MMP-3及CRP水平均高于术后3 d(P<0.05);非感染组术后24 h CRP及MMP-3水平高于术前及术后3 d(P<0.05)。术后24 h及3 d感染组血清sTREM-1、s ICAM-1、CRP及MMP-3水平均高于非感染组(P<0.05)。术后24 h血清sTREM-1、sICAM-1、CRP及MMP-3水平单独及联合预测评估术后切口感染发生的ROC-AUC(0.95%CI)分别为0.794(0.638~0.989)、0.766(0.592~0.991)、0.792(0.658~0.953)、0.739(0.570~0.958)、0.851(0.778~0.931)。结论:肛瘘镜下手术治疗肛瘘患者有术后切口感染风险,术后24 h血清sTREM-1、sICAM-1、CRP及MMP-3水平对术后切口感染的发生有一定预测价值,4者联合检测的预测价值更高。
Objective: To investigate the predictive effect of serum soluble myeloid cell triggering receptor 1(sRM-1), soluble intercellular adhesion molecule-1(sICAM-1), C-reactive protein(CRP) combined with matrix metalloproteinase-3(MMP-3) on incision infection in anal fistula patients under minimally invasive surgery.Methods: A total of104 anal fistula patients under minimally invasive surgery in our hospital from January 2019 to June 2020 were enrolled in this study. The serum sRM-1, sICAM-1, CRP and MMP-3 levels were detected by enzyme-linked immunoassay before surgery and after 24 h and 3 d of surgery. Patients were divid-ed into infection group and non-infection groupaccording to whether postoperative incision infection occurred.ROC curve was used to analyze the predictive and evaluation effects of the above indicators on postoperative incision infection. Results: Postoperative incision infection occurred in 16 patients(15.4%), and no incision infection occurred in 88 patients(84.6%). Serum levels of sRM-1, sICAM-1, CRP and MMP-3 were increased after 24 h and 3 d of surgery in infection group, and it was higher at 24 h post-surgery(P<0.05). In non-infection group, serum level of CRP at 24 h after surgery was higher than that before surgery and 3 d after surgery(P<0.05). Serum sRM-1, sICAM-1, CRP and MMP-3 levels in infection group were higher than those in non-infection group 24 h and 3 days after operation(P<0.05). The ROC-AUC(0.95%CI) of serum sRM-1, s ICAM-1, CRP and MMP-3 were 0.794(0.638-0.989), 0.766(0.592-0.991), 0.792(0.658-0.953), 0.739(0.570-0.958), and 0.851(0.778-0.931), respectively 24 h after surgery. Conclusion:There is a risk of incision infection in patients with anal fistula after minimally invasive surgery. The levels of serum sRM-1, SICAM-1, CRP and MMP-3 at 24 h after surgery have a certain predictive value for the occurrence of postoperative incision infection, and the combined detection has a higher predictive value.
作者
夏长河
刘芳
张傲
夏长江
吴晓华
闫丽丽
宋春光
Xia Changhe;Liu Fang;Zhang Ao;Xia Changjiang;Wu Xiaohua;Yan Lili;Song Chunguang(Department of Anorectal Surgery,The First Hospital of Qi-nhuangdao,Qinhuangdao 066000,China;Physical Examination Center,The First Hospital of Qi-nhuangdao,Qinhuangdao 066000,China;Department of Pharmacy,Tangshan People's Hospital,Tangshan 063000,China;Gastroenterology Department,The First Hospital of Qi-nhuangdao,Qinhuangdao 066000,China)
出处
《广西医科大学学报》
CAS
2021年第6期1155-1160,共6页
Journal of Guangxi Medical University
基金
河北省卫生健康委员会基金项目(No.20191387)
秦皇岛市科学技术研究与发展计划(No.201902A171)。
