Wang Yi, Zhang Wenhui, Liu Shourong, Wang Fei, Huang Qian, Li Er, Zhu Mingli, Yu Jianhua, Shi Jinchuan
Department of Infection, Affiliated Hangzhou Xixi Hospital, Zhejiang University of Traditional Chinese Medicine, Hangzhou, People's Republic of China.
Institute of Hepatology and Epidemiology, Affiliated Hangzhou Xixi Hospital, Zhejiang University of Traditional Chinese Medicine, Hangzhou, People's Republic of China.
J Inflamm Res. 2024 Sep 9;17:6239-6250. doi: 10.2147/JIR.S472800. eCollection 2024.
Precise prediction of the occurrence of complicated perianal abscesses (PAs) in monkeypox (mpox)-infected patients is important for therapeutic optimization. This study sought to identify risk factors of complicated PA.
A total of 48 patients with mpox infection (PA group, n = 10; non-PA (NPA) group, n = 38) were enrolled in our study, who were hospitalized in Hangzhou Xixi Hospital, China from 29 June to 3 September 2023. The data of demographic characteristics, and clinical symptoms, serum SAA, PCT, CRP, and IL-6 levels were collected by the Electronic Medical Record. The diagnostic values of these biomarkers were assessed using multivariate logistic regression and ROC curve analyses.
A decrease in serum IL-6, SAA, and CRP levels (all < 0.05), but not PCT, was observed in all mpox-infected patients. A significant positive correlation was also noted between IL-6, SAA, CRP, and PCT levels (all < 0.05). There was a significant increase in IL-6 and SAA levels and the SAA/CRP ratio in serum samples from patients in the PA group. Multivariate logistic regression and ROC curve analyses identified that the combined use of perianal symptoms and SAA was more sensitive than perianal symptoms or SAA alone as predictors of complicated PA. This combination had the highest predictive value for disease progression, with an AUC of 0.920 ( < 0.001).
The combination of perianal symptoms and SAA levels was strongly linked to the occurrence of complicated PA in mpox-infected patients. These findings may inform the early diagnosis of this patient population.
精确预测猴痘（mpox）感染患者复杂肛周脓肿（PA）的发生对于优化治疗至关重要。本研究旨在确定复杂PA的危险因素。
共有48例猴痘感染患者（PA组，n = 10；非PA（NPA）组，n = 38）纳入我们的研究，他们于2023年6月29日至9月3日在中国杭州西溪医院住院。通过电子病历收集人口统计学特征、临床症状、血清SAA、PCT、CRP和IL - 6水平的数据。使用多因素逻辑回归和ROC曲线分析评估这些生物标志物的诊断价值。
在所有猴痘感染患者中观察到血清IL - 6、SAA和CRP水平下降（均<0.05），但PCT未下降。IL - 6、SAA、CRP和PCT水平之间也存在显著正相关（均<0.05）。PA组患者血清样本中的IL - 6和SAA水平以及SAA/CRP比值显著升高。多因素逻辑回归和ROC曲线分析确定，肛周症状和SAA联合使用作为复杂PA的预测指标比单独使用肛周症状或SAA更敏感。这种组合对疾病进展的预测价值最高，AUC为0.920（<0.001）。
肛周症状和SAA水平的组合与猴痘感染患者复杂PA的发生密切相关。这些发现可能为该患者群体的早期诊断提供依据。
