中国肛肠病杂志2025，Vol.45Issue(11)：42-45,4.
肛周坏死性筋膜炎患者血液指标及微生物分布对疾病临床结局的预测价值
Predictive Value of Blood Indicators and Microbial Distributions in Patients with Perianal Necrotizing Fasciitis for Clinical Outcome of Disease
摘要
Abstract
Objective To explore the predictive value of blood indicators and microbial distributions in patients with perianal necrotizing fasciitis(PNF)for the clinical outcome of the disease.Methods The data of 80 patients with PNF admitted to our hospital from January 2022 to April 2025 were retrospectively col-lected,including basic information[gender,age and body mass index(BMI)],complications,history of colorectal surgery,course of disease(time from the appearance of clinical symptoms to the first surgical inter-vention),preoperative hematological indicators and microbial culture results.Hematological indicators included white blood cell count(WBC),neutrophil ratio(NEU),C-reactive protein(CRP),tumor necrosis factor(TNF),interleukin-6(IL-6),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),alanine aminotransferase(ALT),serum creatinine(sCr)and blood urea nitrogen(BUN).According to the clinical outcome of the disease,the patients were divided into a survival group(n=66)and a death group(n=14),and the predictive value of each indicators for the clinical outcome of PNF was assessed.Results The male-to-female ratio of the patients was 7.89∶1.The most common complication was diabetes mellitus(36.25%),followed by hypertension(18.75%)and obesity(17.50%).Those with a history of colorectal surgery accounted for 15.00%.Among the 73 patients(91.25%),a total of 83 patho-genic bacteria were isolated through microbiological culture.Among them,10 cases(12.50%)showed mixed infections(culturing out≥2 types of bacteria),and the bacterial species were diverse,with Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,Streptococcus,and Bacteroides fragilis being the most com-mon.There were statistically significant differences in WBC,NEU,CRP,TNF,APTT and BUN between the death group and the survival group(P<0.05).Multivariate Logistic regression analysis showed that WBC and BUN were independent influencing factors for the clinical outcome of patients with PNF(P<0.05).ROC curve analysis showed that the areas under the curve(AUC)of WBC and BUN for predicting the clinical outcome were 0.798 and 0.807 respectively,with significant effects(both P<0.001).When the two were combined for prediction,the AUC reached 0.878(95%CI:0.766-0.990),with a better effect(P<0.001).Conclusion WBC and BUN are independent predictive indicators for the clinical outcome of patients with PNF.Clinically,dynamic monitoring of these indicators should be strengthened and timely inter-ventions should be carried out.关键词
肛周坏死性筋膜炎/血液指标/微生物分布/临床结局Key words
Perianal necrotizing fasciitis/Blood indicators/Microbial distribution/Clinical outcome引用本文复制引用
赵丽,曹暂剑,乔峰妮..肛周坏死性筋膜炎患者血液指标及微生物分布对疾病临床结局的预测价值[J].中国肛肠病杂志,2025,45(11):42-45,4.基金项目
四川省中医药管理局项目(2023ms176) （2023ms176）
