胰岛素样生长因子-1与血脂指标对肛瘘镜下手术治疗肛瘘患者切口愈合的预测价值  

Predictive value of insulin-like growth factor-1 and blood lipid indexes on incision healing in patients with anal fistula treated by endoscopic surgery

作　　者：夏长河 刘芳 张傲 夏长江 何峰 闫丽丽[4] 吴晓华[1] Xia Changhe;Liu Fang;Zhang Ao;Xia Changjiang;He Feng;Yan Lili;Wu Xiaohua(Department of Anorectal Surgery,The First Hospital of Qinhuangdao,Qinhuangdao 066000,China;Physical Examination Center,The First Hospital of Qinhuangdao,Qinhuangdao 066000,China;Department of Pharmacy,Tangshan People's Hospital,Tangshan 063000,China;Department of Gastroenterology,The First Hospital of Qinhuangdao,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第一医院肛肠外科,秦皇岛066000 [2]河北省秦皇岛市第一医院体检中心,秦皇岛066000 [3]河北省唐山市人民医院药剂科,唐山063000 [4]河北省秦皇岛市第一医院消化内科,秦皇岛066000

出　　处：《广西医科大学学报》2021年第2期326-331,共6页Journal of Guangxi Medical University

基　　金：河北省卫生健康委员会基金资助项目(No.20191387);河北省秦皇岛市科学技术研究与发展计划资助项目(No.201902A171)。

摘　　要：目的:探讨胰岛素样生长因子-1(IGF-1)与血脂指标对肛瘘镜下手术治疗肛瘘患者切口愈合的预测价值。方法:选取秦皇岛市第一医院2019年1月至2020年7月收治的112例行肛瘘镜下手术治疗的肛瘘患者,根据术后切口恢复情况分为甲组(切口甲级愈合,92例)和乙组(切口乙级愈合,20例),比较两组IGF-1、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)等指标水平,采用多因素分析法探讨影响伤口愈合的危险因素。结果:甲组平均年龄小于乙组,糖尿病比例、术前血糖水平均明显低于乙组,白蛋白、HDL-C及IGF-1水平均明显高于乙组(均P<0.05)。多因素分析结果显示,术前高血糖水平、低白蛋白水平、低HDL-C水平及低IGF-1水平是影响肛瘘镜术后乙类切口愈合的危险因素(均P<0.05)。受试者工作特征(ROC)曲线显示,术前血糖、HDL-C、IGF-1水平及三者联合应用对乙类切口愈合有较高的预测价值。结论:术前高血糖水平、低白蛋白水平、低HDL-C水平及低IGF-1水平是肛瘘镜术后出现乙类切口愈合的危险因素,且术前血糖、HDL-C及IGF-1联合检测对其有较高的预测价值。Objective:To explore the predictive value of insulin-like growth factor-1(IGF-1)and blood lipid indexes on incision healing in patients with anal fistula treated by endoscopic surgery for anal fistula. Methods:From January 2019 to July 2020, 112 patients undergoing anal fistula endoscopic surgery in our hospital were selected. According to the postoperative incision recovery, they were divided into group A(incision A healing) and group B(incision B healing). IGF-1, high-density lipoprotein(HDL-C), low-density lipoprotein(LDL-C) and other blood lipid indexes of the two groups were compared. Results:The proportion of diabetes, the average age, and preoperative blood sugar of group A were lower than those of group B, whereas the levels of Hb, albumin, HDLC and IGF-1 of group A were higher(P<0.05). Multivariate analysis results showed that high blood glucose level, low albumin level, low HDL-C level and low IGF-1 level were the risk factors affecting the healing of type B incision after anal fistula endoscopic surgery(P<0.05). ROC analysis showed that preoperative blood glucose,HDL-C, IGF-1 levels, and combined detectionof the three indicators had higher predictive value for the healing of type B incisions. Conclusion: High preoperative blood glucose, low albumin, low HDL-C and low IGF-1 are the risk factors for type B incision healing after fistula endoscopic surgery, and thecombined detection of preoperative blood glucose, HDL-C and IGF-1 has high predictive value.

关 键 词：胰岛素样生长因子-1 血脂 高密度脂蛋白 肛瘘镜 切口愈合 

分 类 号：R587.1[医药卫生—内分泌] R657.1[医药卫生—内科学]