摘要
目的 研究隆乳术患者血清白细胞介素-6(IL-6)和Toll样受体2(TLR-2)水平及临床资料,探讨术后假体周围感染发生的风险并构建预测隆乳术后假体周围感染风险列线图模型。方法 选择2019年2月—2022年2月于某院行隆乳术的患者作为研究对象。将患者分为感染组和未感染组,对患者一般资料、临床参数及血清IL-6、TLR-2水平进行单因素分析,初步筛选影响隆乳术后假体周围感染发生的危险因素;再采用多因素logistic回归分析,进一步筛选独立危险因素。依据筛选出的因素构建预测隆乳术后假体周围感染列线图模型,并验证此模型。结果 共纳入446例行隆乳术患者,平均年龄(28.50±3.39)岁。其中感染组42例(9.42%),未感染组404例(90.58%)。感染组患者IL-6和TLR-2水平高于未感染组,差异有统计学意义(P<0.05),筛选出合并糖尿病、乳腺炎病史、C反应蛋白(CRP)、白细胞(WBC)、IL-6和TLR-2水平是术后假体周围发生感染的独立危险因素,根据筛选出的危险因素构建的列线图预测模型,内部验证前后受试者工作特征(ROC)曲线下面积(AUC)值分别为0.858(95%CI:0.804~0.911)和0.842(95%CI:0.799~0.890),切点值为0.56,内部验证前后灵敏度分别为88.1%、88.2%,特异度分别为92.3%、91.7%,准确度良好。结论 合并糖尿病、乳腺炎病史,CRP、WBC、IL-6和TLR-2水平对隆乳术后假体周围感染具有较强的预测能力。基于这些危险因素构建的列线图预测隆乳术后假体周围感染风险,可帮助临床医生为患者提供定制化的临床治疗方案,降低术后感染风险。
Objective To explore the risk of post-periprosthetic infection and construct a nomogram model for predicting the risk of peri-prosthetic infection after mammoplasty through studying serum interleukin-6(IL-6)and toll-like receptor 2(TLR-2)levels as well as clinical data of patients who underwent mammoplasty.Methods Patients who underwent mammoplasty in a hospital from February 2019 to February 2022 were selected as research subjects and divided into the infected and non-infected groups.Univariate analysis was performed to analyze patients’general condition,clinical parameters,as well as serum IL-6 and TLR-2 levels,Risk factors affecting the occurrence of peri-prosthetic infection after mammoplasty were preliminarily screened.Independent risk factors were further screened with multivariate logistic regression analysis.A nomogram model for predicting the risk of peri-prosthetic infection after mammoplasty was constructed and validated.Results A total of 446 patients who underwent mammoplasty were included in the analysis,with an average age of(28.50±3.39)years old.Forty-two cases(9.42%)were devi-ded into the infected group and 404 cases(90.58%)in the non-infected group.The levels of IL-6 and TLR-2 in the infected group were significantly higher than those in the non-infected group,with statistically significant difference(P<0.05).Independent risk factors,including the history of diabetes and mastitis,C-reactive protein(CRP),white blood cell(WBC),as well as IL-6 and TLR-2 levels,were independent risk factors for post-periprosthetic infection after mammoplasty.Based on the screened risk factors,a nomogram model was constructed.The area under the curve(AUC)of receiver operating characteristic(ROC)curve before and after internal validation were 0.858(95%CI:0.804-0.911)and 0.842(95%CI:0.799-0.890),respectively.The cut-off value was 0.56.The sensitivity before and after internal validation were 88.1%and 88.2%,respectively,and the specificity were 92.3%and 91.7%,respectively,indicating good accuracy.Conclusion The history of diabetes and mastitis,CRP,WBC,IL-6 and TLR-2 levels have a good predictive ability for peri-prosthetic infection after mammoplasty.The nomogram model constructed based on these risk factors can predict the risk of peri-prosthetic infection after mammoplasty,which can assist clinicians to develop individualized treatment plans for patients and reduce the risk of post-operative infection.
作者
马云鹏
李艳
韩朋
苏晓光
MA Yun-peng;LI Yan;HAN Peng;SU Xiao-guang(Department of Plastic Surgery,The Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Urology,Hebei People’s Hospital,Shijiazhuang 050000,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2023年第9期1042-1049,共8页
Chinese Journal of Infection Control
