【摘要】 目的 研究血清肿瘤坏死因子（TNF-α）、基质细胞衍生因子-1(SDF-1)、血管内皮生长因子（VEGF）水平与断指再植术后感染的关系。方法 选择2019年3月至2021年3月于秦皇岛市第二医院实施断指再植术治疗的84例患者，统计感染情况将受试者分为感染组和未感染组，对比两组及感染组中急性期与恢复期血清TNF-α、SDF-1及VEGF水平，分析影响断指再植术后感染的相关因素。结果 经过统计随访资料，本次研究中9例患者出现感染（感染组），感染率为10.71%，其中75例未发生感染（未感染组），占比89.29%。感染组血清TNF-α、SDF-1及VEGF水平高于未感染组，差异有统计学意义（t=19.067、23.481、50.233,P<0.05）。急性期患者血清TNF-α、SDF-1及VEGF高于恢复期，差异有统计学意义（t=10.266、8.465、8.346,P<0.05）。经非条件多因素logistic回归模型分析得，受伤至手术时间、断指端污染严重、血清TNF-α、SDF-1及VEGF为影响断指再植术感染的独立危险因素（χ~2/t=5.019、5.040、19.067、23.481、50.233,P<0.05）。结论 血清TNF-α、SDF-1及VEGF水平影响断指再植术感染的相关危险因素，通过检测三者水平可评估病情进展情况、降低术后感染率。更多还原

【Abstract】 Objective To investigate the relationship between the serum levels of tumor necrosis factor-α(TNF-α)and stromal cell derived factor 1(SDF-1),vascular endothelial growth factor(VEGF)and infection after replantation of severed finger. Methods A total of 84 patients who underwent severed finger replantation in Qinhuangdao Second Hospital from March 2019 to March 2021 were selected. The infection status was counted and the subjects were divided into infection group and non-infection group. The serum levels of TNF-α,SDF-1 and VEGF were compared between the two groups and the infection group in the acute phase and recovery phase,and the related factors affecting infection after replantation of amputated fingers were analyzed. Results According to statistical follow-up data,9 patients in this study developed infection(infection group),and the infection rate was 10.71%,and 75 patients did not develop infection(non-infection group),accounting for 89.29%. The serum levels of TNF-α,SDF-1 and VEGF in the infection group were higher than those in the non-infection group,and the difference was statistically significant(t=19.067,23.481,50.233,P<0.05). The serum TNF-α,SDF-1 and VEGF in acute stage were higher than those in recovery stage,and the difference was statistically significant(t=10.266,8.465,8.346,P<0.05). Non-conditional multivariate logistic regression analysis showed that the time from injury to operation,severe contamination of severed finger end,serum TNF-α,SDF-1 and VEGF were independent risk factors for infection of severed finger replantation（χ~2/t=5.019,5.040,19.067,23.481,50.233,P<0.05）. Conclusion The serum levels of TNF-α,SDF-1 and VEGF affect the risk factors of infection in replantation of severed finger,and the detection of the three levels can evaluate the progress of the disease and reduce the postoperative infection rate.更多还原