炎性因子水平对结直肠癌合并糖尿病患者术后感染的预测价值  

Predictive value of inflammatory factor levels for postoperative infection of patients with colorectal cancer combined with diabetes

作　　者：杨松鹏 杜昕 刘寒松 YANG Songpeng;DU Xin;LIU Hansong(Department of Gastrointestinal Hernia and Abdominal Wall Surgery,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,He’nan,China)

机构地区：[1]郑州大学附属郑州中心医院胃肠疝和腹壁外科,郑州4500070

出　　处：《癌症进展》2020年第15期1559-1562,共4页Oncology Progress

摘　　要：目的探讨可溶性细胞间黏附分子1(sICAM-1)、基质金属蛋白酶12(MMP12)、C反应蛋白(CRP)和白细胞介素-17(IL-17)对结直肠癌合并糖尿病患者术后感染的预测价值。方法将81例经手术治疗的结直肠癌合并糖尿病患者中未发生术后感染的患者作为未感染组(n=60),发生术后感染的患者作为感染组(n=21),比较两组患者sICAM-1、MMP12、CRP、IL-17等炎性因子水平。分析术后感染患者的病原菌分布情况,Logistic回归分析探讨影响结直肠癌合并糖尿病患者术后感染的危险因素。结果81例经手术治疗的结直肠癌合并糖尿病患者中,发生术后感染21例,感染率为25.93%,以革兰阴性菌感染为主。未感染组患者血清sICAM-1、MMP12、CRP、IL-17水平均明显低于感染组患者,差异均有统计学意义(P<0.01)。单因素分析结果显示,不同围手术期血糖控制情况、TNM分期、手术开放程度、术中出血量、sICAM-1水平、MMP12水平、CRP水平和IL-17水平结直肠癌合并糖尿病患者术后感染率比较,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,sICAM-1≥211.0μg/L、MMP12<80.0mg/L或>140.0mg/L、CRP<0.8mg/L或>8.0mg/L、IL-17≥20.0ng/L、围手术期血糖控制不佳是结直肠癌合并糖尿病患者术后感染的独立危险因素(P<0.05)。结论发生术后感染的结直肠癌合并糖尿病患者的sICAM-1、MMP12、CRP、IL-17等炎性因子明显较高,炎性因子水平较高的患者发生术后感染率更高,故应选择手术开放程度较小的腹腔镜手术方式,改善临床症状,从而减少患者术后感染的发生风险。Objective To investigate the predictive value of soluble intercellular adhesion molecule-1(sICAM-1),matrix metalloproteinase 12(MMP12),C reactive protein(CRP) and interleukin-17(IL-17) of patients with colorectal cancer combined with diabetes for postoperative infection.Method 81 cases of colorectal cancer patients with diabetes after operation were selected as the uninfected group(n=60),and the patients with postoperative infection as the infection group(n=21).The levels of sICAM-1,MMP12,CRP,IL-17 and other lnnammatory factors were compared between the two groups.The distnbution of pathogens inpatients with postoperative infection was analyzed.Logistic regression analysis was used to explore the risk factors of postoperative infection in patients with colorectal cancer and diabetes.Result In the 81 patients with colorectal cancer and diabetes treated by surgery,21 cases had postoperative infections,the mcidence of postoperative infections was 25.93%,and infection of Gram-negative bacteria was dominating.The levels of sICAM-1,MMP12,CRP,and IL-17 of patients in the infection group were significantly higher than those in the uninfected group,and the differences were statistically significant(P<0.01).Umvanate analysis showed that,diferent perioperative blood glucose control,TNM staging,surgical openness,intraoperative blood loss,sICAM-1 level,MMP12 level,CRP level and IL-17 level are compared with postoperative infection rates in patients with colorectal cancer and diabetes(P<0.05).Logistic regression analysis showed that sICAM-1≥211.0μg/L,MMP12<80.0 mg/L or>140.0 mg/L,CRP<0.8 mg/L or>8.0 mg/L,E,-17≥20.0 ng/L and poor penoperative blood glucose control were independent risk factors for the postoperative infection in patients with colorectal cancer and diabetes(P<0.05).Conclusion The inflammatory factors such as sICAM-1,MMP12,CRP,and IL-17 in patients with colorectal cancer and diabetes who have postoperative infection are significantly higher,and patients with higher levels of lnflamiriatory factors have a high

关 键 词：结直肠癌 糖尿病 可溶性细胞间黏附分子1 基质金属蛋白酶12 炎性因子 

分 类 号：R735.3[医药卫生—肿瘤]