下肢丹毒住院患者复发情况及远期危险因素研究

Study on Recurrence and Long-Term Risk Factors of Inpatients with Lower Limb Erysipelas

目的比较单次发作和反复发作的下肢丹毒(LLE)住院患者的合并症和实验室结果,以确定复发的丹毒/蜂窝织炎的危险因素。方法采用回顾性研究,筛选2009年6月至2023年6月在北京中医医院疮疡血管外科住院患者的病历资料。结果共纳入137份病历资料,其中复发患者45例,单次发作(1年内未复发)92例。复发组与未复发组在合并足癣、使用中药塌渍、治疗前白细胞总数、中性粒细胞绝对值、PT、INR、血清钠离子、治疗后症状评分(总分、皮肤颜色、肿胀、皮肤温度、疼痛)、总体疗效方面差异具有统计学意义(P<0.05)。Logistic回归分析和生存分析显示,患有足癣、治疗前中性粒细胞绝对值较高、总体疗效较差的患者更易复发。结论合并足癣、治疗前中性粒细胞较高、治疗后症状改善程度较差的患者应被视为丹毒复发的高危人群,需在临床治疗中予以重视。

Objective:To compare the comorbidities and laboratory results of single-episode and recurrent inpatients with lower limb erysipelas(LLE)to identify risk factors for recurrent erysipelas/cellulitis.Methods:A retrospective study was conducted to screen the medical records of inpatients in the Department of Vascular Surgery of Sores and Ulcers in Beijing Hospital of Traditional Chinese Medicine from June 2009 to June 2023.Results:A total of 137 medical records were included,including 45 patients with recurrence and 92 patients with a single episode(no recurrence within 1 year).There were statistically significant differences between the recurrence group and the non-recurrence group in terms of tinea pedis,slump stains with traditional Chinese medicine,total number of white blood cells before treatment,absolute neutrophil value,PT,INR,serum sodium,symptom score(total score,skin color,swelling,skin temperature,pain)and overall efficacy between the recurrence group and the non-recurrence group(P<0.05).Logistic regression analysis and survival analysis showed that patients with tinea pedis,high absolute neutrophil values before treatment,and poor overall efficacy were more likely to relapse.Conclusion:Patients with tinea pedis,high neutrophils before treatment,and poor symptom improvement after treatment should be regarded as a high-risk group for erysipelas recurrence and should be paid attention to in clinical treatment.