首页|血清HIF-1α、VEGF、sTREM-1及炎症因子与肛瘘术后切口感染的相关性

血清HIF-1α、VEGF、sTREM-1及炎症因子与肛瘘术后切口感染的相关性

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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与炎症因子存在负相关。
The correlation between serum HIF-1 α,VEGF,sTREM-1 and inflammatory factors and incision infection after anal fistula surgery
Objective To 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.Methods A 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-1 α,VEGF,sTREM-1 and inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor α(TNF-α)]between the infected and non infected groups were compared,and the correlation between CRP,IL-6,TNF-α,HIF-1 α,VEGF,sTREM-1 and postoperative infection of anal fistula was analyzed by Pearson correlation coefficient;The correlation between CRP,IL-6,TNF-α and HIF-1 α,VEGF,sTREM-1.And the efficacy of serum HIF-1 α,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.Results The levels of serum HIF-1 α,sTREM-1,CRP,IL-6,and TNF-α in 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-α were 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-α were positively correlated with HIF-1 α and sTREM-1(r=0.574/0.611/0.653,0.661/0.608/0.610,all P<0.05),while CRP,IL-6,TNF-α were negatively correlated with VEGF(r=-0.200,-0.207,-0.254,all P<0.05).The area under the curve(AUC)of HIF-1 α,VEGF,sTREM-1,CRP,IL-6,and TNF-α for diagnosing incision infection after anal fistula surgery were 0.716,0.787,0.741,0.678,0.792,and 0.688,respectively.The AUC of the combined diagnosis of inflammatory factors and 6 data points for postoperative incision infection in anal fistula surgery were 0.836 and 0.921,respectively.Conclusions Serum levels of HIF-1 α,sTREM-1,CRP,IL-6,and TNF-α are abnormally high in patients with incision infection after anal fistula surgery,while VEGF is abnormally low in expression.HIF-1 α,VEGF,sTREM-1,and inflammatory factors can be used as effective indicators for clinical diagnosis of incision infection after anal fistula surgery,and their combined diagnostic value is better.HIF-1 α and sTREM-1 are positively correlated with inflammatory factors,while VEGF is negatively correlated with inflammatory factors.

Surgical wound infectionAnal fistulaHypoxia-inducible factor 1,alpha subunitVascular endothelial growth factorsTriggering receptor expressed on myeloid cells-1

刘勇桃、李扬轶、黄娟

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成都市双流区第一人民医院 四川大学华西空港医院中医肛肠科,成都 610200

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

2024

中国医师杂志
中华医学会 湖南省医学会

中国医师杂志

CSTPCD
影响因子:0.876
ISSN:1008-1372
年,卷(期):2024.26(8)