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投稿时间：2024-10-11 网络发布日期：2025-08-20
投稿时间：2024-10-11 网络发布日期：2025-08-20
中文摘要: 目的 探讨翼状胬肉切除联合角膜缘干细胞移植术后感染发生状况及风险因素，并构建列线图预测模型。方法 选取2018年5月至2023年5月马鞍山市人民医院收治的120例翼状胬肉患者，根据患者术后是否继发感染分为感染组（13例）和未感染组（107例），收集并分析两组患者一般资料及临床资料，采用多因素logistic回归分析感染发生的影响因素。结果 术后有13例患者发生感染，107例未感染，感染率为10.83%,其中细菌感染9例，真菌感染4例。单因素分析显示，感染组患者复发性胬肉、角膜缝线断裂、激素药物使用、合并糖尿病占比均高于未感染组（P<0.05）。两组在年龄、工作环境、性别、吸烟史、酗酒史、高血压、冠心病、病程、胬肉分期和胬肉大小等方面相比，差异无统计学意义（P>0.05）。多因素logistic回归分析结果显示，激素药物使用、角膜缝线断裂、复发性胬肉、合并糖尿病是影响翼状胬肉术后继发感染的危险因素（P＜0.05）。基于上述危险因素构建列线图风险预测模型，校准曲线显示一致性指数（C-index）为0.854（95%CI：0.711~0.936），Hosmer-Lemeshow拟合优度检验显示，实际概率与预测概率差异无统计学意义（χ2=6.098，P>0.05），受试者工作特征（ROC）曲线下面积（AUC）为0.804（95%CI：0.722~0.885），灵敏度、特异度分别为77.61%、67.92%。结论 合并糖尿病、激素药物使用、角膜缝线断裂、复发性翼状胬肉是影响翼状胬肉术后发生感染的危险因素。基于此构建的列线图模型对翼状胬肉切除联合角膜缘干细胞移植术后感染发生具有良好的预测能力。
Abstract:Objective To investigate the incidence and risk factors of infection after pterygium excision combined with limbal stem cell transplantation（LSCT），and to construct a nomogram prediction model. Methods A total of 120 patients with pterygium treated in Maanshan People's Hospital from May 2018 to May 2023 were selected. Patients were divided into infected group（13 cases）and uninfected group（107 cases）according to whether they had secondary infection after surgery. The general data and clinical data of the two groups were collected and analyzed, and the influencing factors of infection were analyzed through multivariate logistic regression analysis. Results There were 13 cases of infection and 107 cases of non-infection after surgery，with an infection rate of 10.83%, including 9 cases of bacterial infection and 4 cases of fungal infection. Univariate analysis showed that the proportion of recurrent pterygium，corneal suture rupture，hormone drug use and diabetes in the infected group were higher than those in the uninfected group（P<0.05）. There was no significant difference between the two groups in age，working environment，gender，smoking and drinking history，hypertension，coronary heart disease，disease course，pterygium stage and pterygium size（P>0.05）. Multivariate logistic regression analysis showed that hormone drug use，corneal suture rupture，recurrent pterygium and diabetes were the risk factors for secondary infection after pterygium surgery（P＜0.05）. The calibration curve showed that the consistency index（C-index）was 0.854（95%CI：0.711-0.936），and the Hosmer-Lemeshow goodness - fit test showed no significant difference between the actual probability and the predicted probability（χ2=6.098，P>0.05）. The area under the receiver operating characteristics（ROC）curve（AUC）was 0.804（95%CI：0.722-0.885），sensitivity and specificity were 77.61% and 67.92%，respectively. Conclusion Diabetes mellitus，hormone
drug use，corneal suture rupture and recurrent pterygium are risk factors for pestoperative pterygium infection. Based on these，the nomogram model construction has a good ability to predict the infection after pterygium excision combined with LSCT.
文章编号： 中图分类号：R777.33 文献标志码：A
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附件
| Author Name | Affiliation |
| WU Jing，TIAN Jingjing，MENG Jie | Department of Ophthalmology,Maanshan People's Hospital,Maanshan,Anhui 243000,China |
引用文本：
吴静，田静静，孟捷.翼状胬肉切除联合角膜缘干细胞移植术后感染风险因素分析及预测模型构建[J].中国临床研究,2025,38(8):1260-1264.
吴静，田静静，孟捷.翼状胬肉切除联合角膜缘干细胞移植术后感染风险因素分析及预测模型构建[J].中国临床研究,2025,38(8):1260-1264.