腹腔引流液TNF-α、IL-6联合血清PCT、CRP检测对结直肠癌术后肠梗阻的预测价值分析  

Value Analysis of Combined Detections of TNF-αand IL-6 in Peritoneal Drainage Fluid and Serum Levels of PCT and CRP in Prediction of Postoperative Intestinal Obstruction in Patients with Colorectal Cancer

作　　者：周春香[1,2] 杨群[3] 武姮静 潘可[2] ZHOU Chun-xiang;YANG Qun;WU Heng-jing;PAN Ke(Department of Nursing,the Second Xiangya Hospital of Central South University,Changsha 410011,China;Department of Gastrointestinal Surgery,the Second Xiangya Hospital of Central South University,Changsha 410011,China;Department of Oncology,the Second Xiangya Hospital of Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院护理教研室,长沙410011 [2]中南大学湘雅二医院胃肠外科,长沙410011 [3]中南大学湘雅二医院肿瘤科,长沙410011

出　　处：《解放军医药杂志》2021年第7期41-45,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：湖南省自然科学基金项目(2020JJ4821)。

摘　　要：目的分析腹腔引流液肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)与血清降钙素原(PCT)、C反应蛋白(CRP)水平对结直肠癌术后肠梗阻发生的预测价值。方法选取我院2019年6月—2020年7月收治的92例结直肠癌,根据术后肠梗阻发生情况分为研究组(发生肠梗阻)和对照组(未发生肠梗阻),比较2组术前、术后当日、术后5 d腹腔引流液TNF-α、IL-6及血清PCT、CRP水平;采用Logistic多因素回归分析结直肠癌患者术后肠梗阻发生的影响因素,并采用受试者工作特征(ROC)曲线分析腹腔引流液TNF-α、IL-6联合血清PCT、CRP检测对患者术后肠梗阻发生的预测价值。结果92例术后5~8 d内发生肠梗阻11例(11.96%)。术后,2组腹腔引流液TNF-α、IL-6及血清PCT、CRP水平较术前明显升高,并随术后时间的延长除研究组血清PCT、CRP水平呈上升趋势外,其他指标水平呈下降趋势,差异有统计学意义(P<0.05);且研究组术后当日、术后5 d时腹腔引流液TNF-α、IL-6及血清PCT、CRP水平均显著高于对照组(P<0.05)。Logistic多因素回归分析结果显示,有吸烟史、有慢性阻塞性肺疾病史及TNF-α、IL-6、PCT、CRP阳性是影响结直肠癌患者术后肠梗阻发生的危险因素(P<0.01)。ROC曲线分析显示,腹腔引流液TNF-α、IL-6及血清PCT、CRP联合检测的曲线下面积最大。结论腹腔引流液TNF-α、IL-6和血清PCT、CRP水平是反映结直肠癌患者炎症反应的敏感指标,临床可通过检测腹腔引流液TNF-α、IL-6与血清PCT、CRP水平评估结直肠癌患者术后肠梗阻发生情况。Objective To analyze values of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)in peritoneal drainage fluid and serum levels of procalcitonin(PCT)and C-reactive protein(CRP)in prediction of postoperative intestinal obstruction in patients with colorectal cancer(CRC).Methods A total of 92 patients with CRC admitted between June 2019 and July 2020 were selected and divided into research group(having intestinal obstruction)and control group(without intestinal obstruction)according to the occurrence of postoperative intestinal obstruction.Levels of TNF-αand IL-6 in peritoneal drainage fluid and serum levels of PCT and CRP before operation,on the day after operation and on the 5th d after operation were compared between two groups.Multivariate logistic regression analysis was used to analyze influencing factors of postoperative intestinal obstruction in patients with CRC,and receiver operating characteristic(ROC)curve was used to analyze values of TNF-αand IL-6 in peritoneal drainage fluid combined with serum detections of PCT and CRP in prediction of postoperative intestinal obstruction in CRC patients.Results Postoperative intestinal obstruction occurred in 11 patients among 92 patients(11.96%)within the 5th-8th d after operation.After operation,TNF-αand IL-6 levels in peritoneal drainage fluid and serum levels of PCT and CRP were significantly higher than those before operation in two groups,and the above levels were decreased with prolonging time after operation(P<0.05).In research group,TNF-αand IL-6 levels in peritoneal drainage fluid and serum levels of PCT and CRP on the day after operation and on the 5th d after operation were significantly higher than those in control group(P<0.05).Results of multivariate logistic regression analysis showed that having smoking history,history of chronic obstructive pulmonary disease,and positive expressions of TNF-α,IL-6,PCT and CRP were risk factors affecting postoperative intestinal obstruction in CRC patients(P<0.01).ROC curve analysis showed that area under the

关 键 词：结直肠肿瘤 肠梗阻 腹腔引流液 肿瘤坏死因子-α 白细胞介素-6 C反应蛋白 影响因素分析 

分 类 号：R735.34[医药卫生—肿瘤]