混合痔术后患者创面愈合不良的影响因素及血清NGF、CXCR4、VEGF对其预测价值  

Influencing factors of poor wound healing in patients after mixed hemorrhoid surgery and the predictive value of serum NGF,CXCR4 and VEGF

作　　者：蔡尚坤[1] 刘顺华 吴宇剑 刘洋 褚立岩 莫毓[1] CAI Shangkun;LIU Shunhua;WU Yujian;LIU Yang;CHU Liyan;MO Yu(Gastrointestinal Surgery Department,the People's Hospital of Hechi,Hechi 547000,China)

机构地区：[1]河池市人民医院胃肠外科,广西河池547000

出　　处：《临床医学研究与实践》2025年第12期21-25,共5页Clinical Research and Practice

基　　金：广西壮族自治区中医药管理局自筹经费科研课题(No.GXZYM20240848)。

摘　　要：目的探讨混合痔术后患者创面愈合不良的影响因素及血清神经生长因子(NGF)、CXC型趋化因子受体4(CXCR4)、血管内皮生长因子(VEGF)对其预测价值。方法选取我院2021年1月至2024年6月收治的221例混合痔手术患者作为研究对象,根据术后创面愈合情况将其分为创面愈合不良组(54例)和创面愈合良好组(167例)。采用单因素、多因素Logistic回归分析混合痔术后患者创面愈合不良的影响因素;比较两组患者的血清NGF、CXCR4、VEGF水平;绘制受试者工作特征(ROC)曲线分析血清NGF、CXCR4、VEGF单独及联合检测对混合痔术后患者创面愈合不良的预测价值。结果两组患者的便秘、合并糖尿病占比比较,差异具有统计学意义(P<0.05);创面愈合不良组的白细胞介素-8(IL-8)、白细胞介素-22(IL-22)水平高于创面愈合良好组,差异具有统计学意义(P<0.05)。创面愈合不良组的NGF、VEGF水平低于创面愈合良好组,CXCR4水平高于创面愈合良好组,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,便秘、合并糖尿病、血清IL-8、IL-22、CXCR4水平偏高及血清NGF、VEGF水平偏低是混合痔术后患者创面愈合不良的影响因素(P<0.05)。ROC曲线分析结果显示,血清NGF、CXCR4、VEGF联合检测诊断混合痔术后患者创面愈合不良的曲线下面积(AUC)高于各项单独检测(P<0.05)。血清NGF、CXCR4、VEGF单独及联合检测时的灵敏度分别为64.81%、74.07%、79.63%及90.74%,特异度分别为70.06%、73.05%、62.28%及86.23%。结论便秘、合并糖尿病、血清IL-8、IL-22、CXCR4水平偏高及血清NGF、VEGF水平偏低是混合痔术后患者创面愈合不良的影响因素,血清NGF、CXCR4、VEGF联合检测在混合痔术后患者创面愈合不良中的预测价值更具优势。Objective To investigate the influencing factors of poor wound healing in patients after mixed hemorrhoid surgery and the predictive value of serum nerve growth factor(NGF),CXC chemokine receptor 4(CXCR4)and vascular endothelial growth factor(VEGF).Methods A total of 221 patients with mixed hemorrhoid surgery admitted in our hospital from January 2021 to June 2024 were selected as the research objects.According to the postoperative wound healing,the patients were divided into poor wound healing group(54 cases)and good wound healing group(167 cases).Univariate and multivariate Logistic regression were used to analyze the influencing factors of poor wound healing in patients after mixed hemorrhoid surgery;the levels of serum NGF,CXCR4 and VEGF were compared between the two groups;the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum NGF,CXCR4 and VEGF alone and in combination for poor wound healing in patients after mixed hemorrhoid surgery.Results There were statistically significant differences in the proportions of constipation and diabetes mellitus between the two groups(P<0.05);the levels of interleukin-8(IL-8)and interleukin-22(IL-22)in the poor wound healing group were higher than those in the good wound healing group,and the differences were statistically significant(P<0.05).The levels of NGF and VEGF in the poor wound healing group were lower than those in the good wound healing group,the level of CXCR4 was higher than that in the good wound healing group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis results showed that constipation,diabetes mellitus,high levels of serum IL-8,IL-22,CXCR4,and low levels of serum NGF and VEGF were the influencing factors of poor wound healing in patients after mixed hemorrhoid surgery(P<0.05).The results of ROC curve analysis showed that the area under curve(AUC)of combined detection of serum NGF,CXCR4 and VEGF in the diagnosis of poor wound healing in patients after mixed hem

关 键 词：神经生长因子 CXC型趋化因子受体4 血管内皮生长因子 混合痔 创面愈合不良 

分 类 号：R657.16[医药卫生—外科学]