sTREM-1、PCT、CD4^+/CD8^+与老年食管癌术后肺部感染相关性及预测价值  

Correlation between levels of sTREM-1, PCT and CD/CD and postoperative lung infection and the predictive value in patients with elderly esophageal cancer

作　　者：李东霞[1] 黄淑俊[2] 邓颖辉[1] 陈泓磊[1] 温月娥[1] LI Dong-xia;HUANG Shu-jun;DENG Ying-hui;CHEN Hong-lei;WEN Yue-e(Sixth Hospital Affiliated to Sun Yat-sen University,Guangzhou,Guangdong510655,China;不详)

机构地区：[1]中山大学附属第六医院外二科,广东广州510655 [2]广东省中医院手术室,广东广州510120

出　　处：《中华医院感染学杂志》2020年第16期2482-2485,共4页Chinese Journal of Nosocomiology

基　　金：广东省医学科研基金资助项目(A2017273)。

摘　　要：目的探讨血清髓样细胞触发受体-1(sTREM-1)、降钙素原(PCT)、CD4^+/CD8^+比值与老年食管癌患者胸腔镜根治术后肺部感染相关性及预测价值。方法选取中山大学附属第六医院2018年1月-2019年7月老年食管癌胸腔镜根治术后发生肺部感染患者46例为试验组,未发生肺部感染患者42例为对照组,检测对比两组血清sTREM-1、PCT、CD4^+/CD8^+比值及肺功能[用力肺活量(FVC)、第1 s用力呼气量(FEV1)、呼气流量峰值(PEF)],分析术后肺部感染影响因素,并比较试验组不同疗效患者感染发生时、治疗48 h后血清sTREM-1、PCT、CD4^+/CD8^+比值,以受试者工作特征(ROC)曲线分析各指标对疗效的预测价值。结果试验组FEV1、PEF低于对照组,血清sTREM-1、PCT高于对照组,CD4^+/CD8^+比值低于对照组(P<0.05);FEV1、PEF、血清sTREM-1、PCT、CD4^+/CD8^+比值均为老年食管癌患者胸腔镜根治术后肺部感染的影响因素(P<0.05);治疗48 h后好转者血清sTREM-1、PCT低于未好转者,CD4^+/CD8^+比值高于未好转者(P<0.05);ROC曲线分析显示,治疗48 h后PCT预测疗效的曲线下面积(AUC)为0.804,高于sTREM-1的0.770及CD4^+/CD8^+比值的0.727。结论老年食管癌患者胸腔镜根治术后肺部感染患者血清sTREM-1、PCT、CD4^+/CD8^+比值存在异常表达,是术后肺部感染发生的影响因素,可通过监测其水平变化为临床治疗及病情评估提供参考依据。OBJECTIVE To investigate the correlation between levels of serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1), procalcitonin(PCT) and CD4^+/CD8^+ ratio and postoperative pulmonary infection and the predictive value in elderly patients with esophageal cancer after thoracoscopy. METHODS From Jan. 2018 to Jul. 2019, 46 elderly patients with pulmonary infection after thoracoscope radical surgery for esophageal cancer in the Sixth Hospital of Sun Yat-sen University were enrolled as the experiment group, and 42 patients without pulmonary infections served as the control group. The serum sTREM-1, PCT, CD4^+/CD8^+ ratio and lung function, which included forced vital capacity(FVC), forced expiratory volume in one second(FEV1)and peak expiratory flow(PEF) were compared between the two groups. The risk factors affecting postoperative lung infection were analyzed. The serum sTREM-1, PCT, CD4^+/CD8^+ ratios in patients with different efficacy in the experimental group when infection occurred and 48 hours after treatment were compared and receiver operating characteristic(ROC) curve was used to analyze the predictive value of each index on the curative effect. RESULTS FEV1, PEF and CD4^+/CD8^+ ratio in the experiment group were significantly lower than that in the control group;serum sTREM-1 and PCT were significantly higher than that in the control group(P<0.05). FEV1, PEF, serum sTREM-1, PCT and CD4^+/CD8^+ ratio were influencing factors of pulmonary infection after thoracoscopy in elderly patients with esophageal cancer(P<0.05). After 48 hours of treatment, the serum levels of sTREM-1 and PCT in patients with a great clinical improvement were significantly lower, whereas the ratio of CD4^+/CD8^+ was significantly higher than that in patients without clinical improvement(P<0.05). ROC curve analysis showed that the area under the curve(AUC) of PCT for predicting the efficacy after 48 hours of treatment was 0.804, which was significantly higher than 0.770 of sTREM-1 and 0.727 of CD4^+/CD8^+ ratio. CONCLUSI

关 键 词：食管癌 胸腔镜根治术 肺部感染 髓样细胞触发受体-1 降钙素原 CD4^+/CD8^+比值 

分 类 号：R619.3[医药卫生—外科学]