炎症负荷指数与口腔颌面部间隙感染严重并发症的相关性

doi:10.13701/j.cnki.kqyxyj.2026.09.012

摘要/Abstract

摘要： 目的:探讨炎症负荷指数(inflammatory burden index,IBI)与口腔颌面部间隙感染(oral and maxillofacial space infection,OMSI)严重并发症的相关性。方法:回顾性分析2020年1月~2025年8月于承德医学院附属医院口腔科收治的264例OMSI患者,根据是否出现严重并发症分为严重并发症组(n=64)和无严重并发症组(n=200)。收集临床及实验室资料。IBI计算公式为C反应蛋白×中性粒细胞绝对值/淋巴细胞绝对值,并对IBI进行自然对数转换(LogIBI)以满足正态性要求。依据LogIBI三分位数将患者分为3组,采用多因素Logistic回归风险模型评估LogIBI与严重并发症的相关性,并进行限制性立方样条分析及敏感性分析。利用受试者工作特征(receiver operating characteristic curve,ROC)曲线评估LogIBI对严重并发症的诊断效能。结果:与非严重并发症组相比,严重并发症组LogIBI值显著升高,且2型糖尿病患病率、牙源性感染及多间隙感染发生率更高,白蛋白水平显著降低,差异均有统计学意义(均P<0.001),随着LogIBI水平的升高,多间隙感染、牙源性感染及严重并发症的比例逐渐升高,白蛋白水平逐渐减低。调整人口统计学特征及潜在临床因素后,LogIBI是严重并发症的独立危险因素(OR=2.72,95%CI:1.45~5.11,P=0.002)。限制性立方样条分析显示LogIBI与严重并发症呈非线性相关(非线性P=0.007)。ROC曲线分析,LogIBI预测严重并发症的曲线下面积(area under the curve,AUC)为0.767,灵敏度为64%,特异度为86%,最佳诊断截断值为3.27。结论:LogIBI升高与口腔颌面部间隙感染严重并发症风险增加相关,是严重并发症的独立危险因素,对严重并发症具有较高的预测价值,可为临床早期风险分层和干预提供依据。

关键词: 口腔颌面部感染, 严重并发症, 炎症负荷指数, Logistic回归分析, 相关性

Abstract: Objective: To investigate the association between the inflammatory burden index (IBI) and severe complications in patients with oral and maxillofacial space infection (OMSI). Methods: A retrospective analysis was performed on 264 patients with OMSI admitted to the Department of Stomatology, Affiliated Hospital of Chengde Medical University, from January 2020 to August 2025. Participants were stratified into severe (n=64) and non-severe complication groups (n=200). Clinical and laboratory data were collected. IBI was calculated as CRP×ANC/ALC, with natural logarithmic transformation (LogIBI) applied to achieve normality. Patients were divided into 3 groups based on the tertiles of LogIBI. Logistic regression assessed the LogIBI-complication association, supplemented by restricted cubic spline (RCS) and sensitivity analyses. The diagnostic efficacy of LogIBI for severe complications was assessed by receiver operating characteristic (ROC) curve. Results: Compared with the non-severe complication group, the severe complication group demonstrated significantly elevated LogIBI values, higher prevalence of type 2 diabetes mellitus, increased incidence of odontogenic infections and multi-space involvement, and reduced albumin levels (all P<0.001). Across ascending LogIBI tertiles, multi-space infections, odontogenic infections, and complications rates increased progressively while albumin decreased. Multivariable adjustment confirmed LogIBI as an independent predictor of severe complications (OR=2.72, 95%CI:1.45~5.11, P=0.002). RCS modelling revealed a non-linear association (nonlinear P=0.007). ROC curve analysis showed that the area under the curve (AUC) of LogIBI for diagnosing severe complications was 0.767, with a sensitivity of 64%, a specificity of 86%, and an optimal diagnostic cutoff value of 3.27. Conclusion: Elevated LogIBI independently predicts severe OMSI complications and demonstrates clinical utility for early risk stratification, potentially informing targeted intervention strategies.

Key words: oral and maxillofacial infection, severe complications, inflammatory burden index, Logistic regression analysis, correlation

张磊, 刘锐, 王雪峰, 霍峰, 陈喜波. 炎症负荷指数与口腔颌面部间隙感染严重并发症的相关性[J]. 口腔医学研究, 2026, 42(9): 799-805.

ZHANG Lei, LIU Rui, WANG Xuefeng, HUO Feng, CHEN Xibo. Association of Inflammatory Burden Index with Severe Complications in Oral and Maxillofacial Space Infections[J]. Journal of Oral Science Research, 2026, 42(9): 799-805.

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