恶性肿瘤合并感染及高水平血清降钙素原患者的临床特征及治疗预后分析  

Clinical Characteristics and Prognosis Analysis of Malignant Tumor Patients Complicated with Infection and High Level of Serum Procalcitonin

作　　者：袁晓丽[1] 董航[1] 谢佳杭[1] 毕刚[1] 王久惠[1] 

机构地区：[1]四川省肿瘤医院综合病区,四川成都610041

出　　处：《四川医学》2017年第2期202-205,共4页Sichuan Medical Journal

摘　　要：目的分析恶性肿瘤合并感染及高水平血清降钙素原(PCT)患者的临床特征及治疗预后影响因素。方法回顾性分析我院从2014年7月至2015年7月,82例恶性肿瘤合并感染且外周血清PCT>30ng/mL的患者,对患者原发肿瘤部位、临床表现、实验室结果、治疗转归等因素进行统计学分析。结果 82例患者中食管癌20例,肺癌8例,头颈部肿瘤8例,胃肠道肿瘤16例,妇科肿瘤16例,其他恶性肿瘤14例。其中感染前行手术30例,放化疗29例,姑息治疗23例;出现发热72例;出现休克表现47例;病原学阳性50例。截至2015年8月随访结束时,因感染死亡32例,死亡率39.02%。死亡组与未死亡组相比,合并年龄>70岁、休克、中性粒细胞比例>90%、治疗后PCT未降、Ⅳ°骨髓抑制差异有统计学意义(P<0.05)。结论恶性肿瘤感染并高水平血清降钙素原的患者预后不良,且与年龄>70岁、休克、中性粒细胞比例>90%、治疗后PCT未降、Ⅳ°骨髓抑制相关。Objective To analyze the clinical characteristics and prognostic factors of patients with malignant tumor complicated with infection and high level of serum procalcitonin（ PCT）.Methods 82 cases of malignant tumor patients complicated with infection and serum PCT level higher than 30 ng / m L,hospitalized between July 2014 and July 2015 in our hospital,were retrospectively analyzed.Factors including primary tumor location,clinical manifestations,laboratory test results,treatment outcome were analyzed statistically.Results There were 20 cases of esophagus cancer,8 cases of lung cancer,8 cases of head and neck tumor,16 cases of gastroenteric tumor,16 cases of gynecological tumor and 14 cases of other malignant tumor in the 82 cases,among which30 cases received operation,29 cases received chemotherapy,23 cases received palliative care before infection and 72 cases developed fever,47 cases occurred shock,50 cases were pathogen-positive.Up to August 2015-the end of follow-up,32 cases died of infection and the mortality reached 39. 02%.Comparing the death group with the survival group,the rates of patients older than 70,occurring shock,having neutrophil ratio bigger than 90%,undiminished PCT level after treatment and Ⅳ° myelosuppression between the two group had statistically significant difference（ P〈0. 05）. Conclusion Malignant tumor patients complicated with infection and high level of serum procalcitonin have poor prognosis,which is associated with patients age more than 70 years old,shock,neutrophil ratio more than 90%,undiminished PCT after treatment and Ⅳ° myelosuppression.

关 键 词：恶性肿瘤 血清降钙素原 感染 预后 

分 类 号：R730.5[医药卫生—肿瘤]