Su Wei, Yang Tao, Hu Xiao-Jun, Song Juan, He Jing-Jing, Huang Dan, Zhang Bo, Zhao Xiao-Ji, Tang Fang
Department of Clinical Laboratory, Mianyang Central Hospital, School of Medicine of University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China.
Department of Clinical Laboratory, Santai Country People's Hospital, Mianyang 621100, Sichuan Province, China.
World J Gastrointest Surg. 2025 Apr 27;17(4):104443. doi: 10.4240/wjgs.v17.i4.104443.
Acute appendicitis, a common condition with a higher prevalence among men, has shown an increasing incidence in recent years owing to lifestyle changes. It is characterized by right lower quadrant abdominal pain, rebound tenderness, and rapid onset. Its pathogenesis is complex and potentially linked to infection, environment, and genetics. Timely intervention is crucial to prevent complications. While surgery is the primary treatment, it carries risks, including postoperative infections that may necessitate re-operation. Gram-negative bacteria release endotoxin (ETX), which induces inflammation and is recognized by toll-like receptor 4 (TLR4). This study evaluated ETX and TLR4 levels in patients with acute appendicitis to assess the risk of postoperative incision infections, aiding in prevention and treatment.
To explore ETX and TLR4 expression in the blood of patients with acute appendicitis and its association with in postoperative incision infection.
A total of 153 patients with acute appendicitis treated at our hospital between April 2022 and March 2024 ( = 153) were included in the study. Patients were categorized into infected ( = 36) and uninfected ( = 117) groups according to the development of postoperative incision infections. General characteristics and blood levels of ETX and TLR4 were compared, and the factors influencing postoperative infection were identified using multivariate logistic regression. ETX and TLR4 predictive values were analyzed using receiver operating characteristic curves.
No statistically significant differences were observed between the two groups in terms of sex, age, or other general characteristics ( > 0.05). Compared to the uninfected group, the infected group had a higher proportion of patients with suppurative or gangrenous appendicitis, longer surgical times, longer incision lengths, and elevated ETX and TLR4 levels ( < 0.05). Multivariate logistic regression analysis identified pathological type, surgical method, surgical time, and incision length as factors influencing postoperative incision infection in acute appendicitis. Receiver operating characteristic curve analysis revealed that both ETX and TLR4 levels were predictive factors for postoperative incision infection, with higher prediction efficiency when combined.
Pathological type, surgical method, surgical time, and incision length significantly influence postoperative incision infection risk in patients with acute appendicitis. Elevated ETX and TLR4 levels serve as valuable predictors of post-appendectomy infections.
急性阑尾炎是一种常见疾病，男性患病率较高，近年来由于生活方式的改变，其发病率呈上升趋势。其特征为右下腹疼痛、反跳痛和起病急。其发病机制复杂，可能与感染、环境和遗传因素有关。及时干预对于预防并发症至关重要。虽然手术是主要治疗方法，但也存在风险，包括术后感染可能需要再次手术。革兰氏阴性菌释放内毒素（ETX），其可诱导炎症反应并被Toll样受体4（TLR4）识别。本研究评估了急性阑尾炎患者的ETX和TLR4水平，以评估术后切口感染的风险，有助于预防和治疗。
探讨急性阑尾炎患者血液中ETX和TLR4的表达及其与术后切口感染的关系。
本研究纳入了2022年4月至2024年3月在我院接受治疗的153例急性阑尾炎患者（n = 153）。根据术后切口感染的发生情况，将患者分为感染组（n = 36）和未感染组（n = 117）。比较两组患者的一般特征以及ETX和TLR4的血液水平，并采用多因素logistic回归分析确定影响术后感染的因素。使用受试者工作特征曲线分析ETX和TLR4的预测价值。
两组患者在性别、年龄或其他一般特征方面均未观察到统计学显著差异（P > 0.05）。与未感染组相比，感染组化脓性或坏疽性阑尾炎患者比例更高，手术时间更长，切口长度更长，ETX和TLR4水平升高（P < 0.05）。多因素logistic回归分析确定病理类型、手术方式、手术时间和切口长度为影响急性阑尾炎术后切口感染的因素。受试者工作特征曲线分析显示，ETX和TLR4水平均为术后切口感染的预测因素，两者联合时预测效率更高。
病理类型、手术方式、手术时间和切口长度显著影响急性阑尾炎患者术后切口感染风险。ETX和TLR4水平升高是阑尾切除术后感染的重要预测指标。
