血清前白蛋白在口腔颌面间隙感染患者的表达及意义

doi:10.19439/j.sjos.2023.02.011

上海口腔医学 ›› 2023, Vol. 32 ›› Issue (2): 172-176.doi: 10.19439/j.sjos.2023.02.011

血清前白蛋白在口腔颌面间隙感染患者的表达及意义

孙岳, 李芳, 张恺, 郑纪伟, 秦莹, 孙晋虎

徐州医科大学口腔医学院,徐州医科大学附属医院口腔颌面外科,江苏徐州 221000

收稿日期:2022-03-24 修回日期:2022-05-12 出版日期:2023-04-25 发布日期:2023-06-13
通讯作者: 孙晋虎,E-mail: kqxsjh@163.com
作者简介:孙岳（1995-）,女,硕士,E-mail: yuesun0310@163.com
基金资助:
江苏省高校自然科学研究计划面上项目（12KJB320015）; 江苏省“六大人才高峰”资助项目（2014-wsw-068）; 徐州市科技计划项目（KC15SH015）

Changes and significance of serum prealbumin expression in patients with oral and maxillofacial space infections

SUN Yue, LI Fang, ZHANG Kai, ZHENG Ji-wei, QIN Ying, SUN Jin-hu

School of Stomatology, Xuzhou Medical University; Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Xuzhou Medical University. Xuzhou 221000, Jiangsu Province, China

Received:2022-03-24 Revised:2022-05-12 Online:2023-04-25 Published:2023-06-13

摘要/Abstract

摘要： 目的: 探讨血清前白蛋白(serum prealbumin, PA)在口腔颌面间隙感染患者中表达水平的变化及意义。方法: 选择徐州医科大学附属医院2020年1月—2021年9月住院治疗的患者分为感染组与非感染组,感染组为121例口腔颌面部间隙中、重度感染患者,非感染组为128例无感染患者。感染组在入院1、3、7天测定PA、超敏C反应蛋白（hs-CRP）和白细胞计数（WBC）水平及相关临床参数。非感染组在入院1天测定PA、hs-CRP及WBC水平。采用SPSS 23.0软件包统计分析PA水平与各实验室及临床参数之间的关系。结果: 入院1天时,感染组PA水平显著低于非感染组。感染组在不同时间点PA水平呈整体上升趋势,且PA与疼痛强度呈负相关,与开口度呈正相关（P<0.05）。PA≤19.85 mg/dL时,诊断敏感度为90.91%,特异度为92.97%,可作为诊断最佳临界值;联合hs-CRP及WBC可提高诊断效能。Logistic回归分析显示,低PA水平为患者术后需要重症监护的独立危险因素（P<0.05）。结论: PA是口腔颌面部间隙感染早期诊断及疗效评价的有效工具,可作为预后评估的参考指标。

关键词: 血清前白蛋白, 感染, 口腔颌面部

Abstract: PURPOSE: To investigate the changes of serum prealbumin (PA) expression level in patients with oral and maxillofacial space infections and its significance. METHODS: Patients hospitalized at the Affiliated Hospital of Xuzhou Medical University from January 2020 to September 2021 were selected and divided into infected and non-infected group. One hundred and twenty-one patients with moderate to severe oral and maxillofacial gap infections were in the infected group, and 128 patients without infection were in the non-infected group. In the infected group, PA, high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC) levels and related clinical parameters were measured at 1, 3 and 7 d of admission. In the non-infected group, PA, hs-CRP and WBC levels were measured at 1 d of admission. SPSS 23.0 software package was used to statistically analyze the relationship between PA levels and various laboratory and clinical parameters. RESULTS: PA levels in the infected group were significantly lower than those in the non-infected group at 1 d of admission. PA levels in the infected group showed an overall increasing trend at different time points, and PA was negatively correlated with pain intensity and positively correlated with mouth opening(P<0.05). The diagnostic sensitivity was 90.91% and the specificity was 92.97% for PA≤19.85 mg/dL, which can be used as the best diagnostic threshold. The diagnostic efficacy can be improved when combined with hs-CRP and WBC. Logistic regression analysis showed that low PA level was an independent risk factor for patients requiring intensive care after surgery (P<0.05). CONCLUSIONS: PA is an effective tool for the early diagnosis and evaluation of the efficacy of oral and maxillofacial interstitial infections, and can be used as a reference indicator to assess prognosis.

Key words: Serum prealbumin, Infection, Oral and maxillofacial region

中图分类号:

R782.3

孙岳, 李芳, 张恺, 郑纪伟, 秦莹, 孙晋虎. 血清前白蛋白在口腔颌面间隙感染患者的表达及意义[J]. 上海口腔医学, 2023, 32(2): 172-176.

SUN Yue, LI Fang, ZHANG Kai, ZHENG Ji-wei, QIN Ying, SUN Jin-hu. Changes and significance of serum prealbumin expression in patients with oral and maxillofacial space infections[J]. Shanghai Journal of Stomatology, 2023, 32(2): 172-176.

参考文献

[1] Li RM, Kiemeney M.Infections of the neck[J]. Emerg Med Clin of North Am, 2019, 37(1): 95-107.
[2] 李云鹏, 石冰, 张浚睿, 等. 口腔颌面部间隙感染诊疗专家共识[J]. 中华口腔医学杂志, 2021, 56(2): 136-144.
[3] 赵小珩, 郭威孝, 张浚睿, 等. 口腔颌面部间隙感染的管理(三)—实验室检查[J]. 实用口腔医学杂志, 2018, 34(3): 424-429.
[4] 郑宏雨, 李紫璇, 牛志兴, 等. 口腔颌面部及颈部多间隙感染合并下行性坏死性纵隔炎多学科协作诊疗的回顾性分析[J]. 中华口腔医学杂志, 2020, 55(12): 952-957.
[5] Lee JL, Oh ES, Lee RW, et al. Serum albumin and prealbumin in calorically restricted, nondiseased individuals: a systematic review[J]. Am J Med, 2015, 128(9): 1023.e1-1023.e22.
[6] Bourguignat A, Férard G, Jenny JY, et al.Diagnostic value of C-reactive protein and transthyretin in bone infections of the lower limb[J]. Clin Chim Acta, 1996, 255(1): 27-38.
[7] 张志愿. 口腔颌面外科学[M]. 第7版. 北京: 人民卫生出版社, 2012: 6.
[8] Shamsaddini A, Gillevet PM, Acharya C, et al. Impact of antibiotic resistance genes in gut microbiome of patients with cirrhosis[J]. Gastroenterology,2021,161(2): 508-521.e7.
[9] Keswani ES, Venkateshwar G.Odontogenic maxillofacial space infections: a 5-year retrospective review in Navi Mumbai[J]. J Maxillofac Oral Surg, 2019, 18(3): 345-353.
[10] Gonda K, Shibata M, Sato Y, et al.Elevated neutrophil-to-lymphocyte ratio is associated with nutritional impairment, immune suppression, resistance to S-1 plus isplatin, and poor prognosis in patients with stage IV gastric cancer[J]. Mole Clin Oncol, 2017, 7(6): 1073-1078.
[11] Salvetti D, Tempel Z, Gandhoke G, et al.Preoperative prealbumin level as a risk factor for surgical site infection following elective spine surgery[J]. Surg Neurol Int, 2015, 6(Suppl 19): S500-S503.
[12] Li Y, Sun Y, He J, et al.Preliminary study on relationships among nutritional risk, serum prealbumin, and peripheral blood T cell subsets in patients with severe COVID-19[J]. Infect Dis (Lond), 2021,53(1): 69-71.
[13] Tempel Z, Grandhi R, Maserati M, et al.Prealbumin as a serum biomarker of impaired perioperative nutritional status and risk for surgical site infection after spine surgery[J]. J Neurol Surg A Cent Eur Neurosurg, 2015, 76(2): 139-143.
[14] Ye S, Lin SP, Wu K, et al.Serum prealbumin is a predictive biomarker for stroke-associated infection after an ischemic stroke[J]. Int J Neurosci, 2017, 127(7): 601-605.
[15] Myron Johnson A, Merlini G, Sheldon J, et al.Clinical indications for plasma protein assays: transthyretin (prealbumin) in inflammation and malnutrition: International Federation of Clinical Chemistry and Laboratory Medicine (IFCC): IFCC Scientific Division Committee on Plasma Proteins(C-PP)[J]. Clin Chem Lab Med, 2007,45(3): 419-426.
[16] Cheng V, Inaba K, Haltmeier T, et al.Serum transthyretin is a predictor of clinical outcomes in critically ill trauma patients[J]. Surgery, 2015, 158(2): 438-444.
[17] Cunningham LL Jr, Madsen MJ, Van Sickels JE.Using prealbumin as an inflammatory marker for patients with deep space infections of odontogenic origin[J]. J Oral Maxillofac Surg, 2006, 64(3): 375-378.
[18] Adeosun PO, Fatusi OA, Adeseji TA.Assessment of severity of illness and monitoring response to treatment of odontogenic space infection using serum prealbumin[J]. J Maxillofac Oral Surg, 2019,18(1): 106-111.
[19] Paul SC, Lv P, Xiao Y, et al.Thalidomide in rat liver cirrhosis: blockade of tumor necrosis factor-α via inhibition of degradation of an inhibitor of nuclear factor-κB[J]. Pathobiology, 2006, 73(2): 82-92.
[20] Llop-Talaveron J, Badia-Tahull MB, Leiva-Badosa E.An inflammation-based prognostic score, the C-reactive protein/albumin ratio predicts the morbidity and mortality of patients on parenteral nutrition[J]. Clin Nutr, 2018, 37(5): 1575-1583.
[21] Liu M, Yang J, Yu X, et al.The role of perioperative oral nutritional supplementation in elderly patients after hip surgery[J]. Clin Interv Aging, 2015, 10: 849-858.
[22] Shenkin A.Serum prealbumin: is it a marker of nutritional status or of risk of malnutrition?[J]. Clin Chem, 2006, 52(12): 2177-2179.

血清前白蛋白在口腔颌面间隙感染患者的表达及意义

Changes and significance of serum prealbumin expression in patients with oral and maxillofacial space infections

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	杜海霞, 危常磊, 张慧, 邓婧, 郭宜青, 郑卫平, 袁昌青. 124例萎缩性舌炎相关因素分析[J]. 上海口腔医学, 2020, 29(4): 423-426.
[2]	宋健, 刘治清, 王晴, 朱卓立, 高波, 杨征. 新型冠状病毒肺炎疫情期间口腔医务人员口罩的选择和使用建议[J]. 上海口腔医学, 2020, 29(4): 435-439.
[3]	廖骞, 李钟仁, 陶疆, 江龙, 杜勤, 朱亚琴. 新型冠状病毒肺炎疫情期间口腔急诊的管理与防控建议[J]. 上海口腔医学, 2020, 29(2): 123-126.
[4]	杨亦婕, 赵隽隽, 朱亚琴. 口腔诊室生物气溶胶传播风险与防护[J]. 上海口腔医学, 2020, 29(2): 127-132.
[5]	王菲, 邱丽华, 庞谅, 万书良. 重庆地区ABO血型与口腔颌面部恶性肿瘤关系的研究[J]. 上海口腔医学, 2020, 29(2): 179-182.
[6]	霍圆圆, 潘永海, 徐薇, 孙燕佩, 刘敏, 张华, 李宁毅. 动态营养支持对口腔颌面肿瘤术后能量代谢、免疫功能及应激反应的影响[J]. 上海口腔医学, 2020, 29(1): 89-92.
[7]	李会旭, 卜令学, 潘克清, 付伟伟, 王亚玲. 口腔颌面部肌内型结节性筋膜炎3例报告及文献复习[J]. 上海口腔医学, 2019, 28(4): 430-434.
[8]	蒲金霞, 李晨曦, 贺多敏, 林兆全, 龚忠诚. 126例口腔颌面部间隙感染患者治疗效果相关影响因素分析[J]. 上海口腔医学, 2018, 27(5): 491-494.
[9]	郭治辰, 胡旻, 龚忠诚, 王岳森. 不同年龄口腔颌面部间隙感染患者的临床特点分析[J]. 上海口腔医学, 2018, 27(5): 538-541.
[10]	刘莹, 金武龙. 口腔颌面部恶性肿瘤患者营养风险评估及相关因素分析[J]. 上海口腔医学, 2017, 26(6): 637-640.
[11]	印志法, 王思明. rhEGF对口腔颌面部外伤患者血清EGF及炎症因子水平的影响[J]. 上海口腔医学, 2017, 26(6): 654-657.
[12]	何思铃, 肖水生. 下颌骨骨折术后感染相关因素分析[J]. 上海口腔医学, 2017, 26(4): 429-433.
[13]	王留宏, 杨政, 杨惠, 娄新田, 王一霖, 戚向群. 口腔颌面清创术后软组织感染的相关因素分析[J]. 上海口腔医学, 2017, 26(4): 461-464.
[14]	邓智元, 方小丹, 潘灏, 胡延佳, 唐瞻贵. 股前外侧肌皮瓣修复颊癌术后缺损23例临床分析[J]. 上海口腔医学, 2017, 26(2): 228-232.
[15]	李丽, 袁卫军, 陈巧露, 姚瑶, 黄莹玭. 口腔颌面部创伤患者创伤后积极心理反应及相关影响因素分析[J]. 上海口腔医学, 2017, 26(1): 102-105.