Bcl-xL蛋白、LDH、IPF、MMP-9在食管癌术后胸腔感染中的表达及预测脓毒症的效能  

Expression of Bcl-xL,LDH,IPF,and MMP-9 in thoracic cavity infection after esophageal cancer surgery and their role in predicting sepsis

作　　者：练冬 金蓓 Dong Lian;Bei Jin(Department of Laboratory Medicine,Second People’s Hospital of Lishui,Lishui 323000,Zhejiang Province,China)

机构地区：[1]浙江省丽水市第二人民医院检验科,浙江省丽水市323000

出　　处：《世界华人消化杂志》2021年第14期788-795,共8页World Chinese Journal of Digestology

摘　　要：背景食管癌患者术后易胸腔感染,但缺乏早期预测机制,基于基质金属蛋白酶-9、未成熟血小板比率、大分子B淋巴细胞瘤、乳酸脱氢酶水平变化均与感染有关,推测可为临床完善相关机制提供参考.目的探讨大分子B淋巴细胞瘤(B-cell lymphoma-extra large,Bcl-xL)蛋白、乳酸脱氢酶(lactate dehydrogenase,LDH)、未成熟血小板比率(immature platelet fraction,IPF)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)在食管癌(esophageal cancer,EC)术后胸腔感染中的表达及预测脓毒症的效能.方法将2016-02/2020-10期间187例EC术后胸腔感染患者作为观察组,并根据是否发生脓毒症分为脓毒症(16例)、非脓毒症(171例)患者,并选取同期临床资料相匹配的187例EC术后未感染患者作为对照组,比较两组及脓毒症、非脓毒症患者Bcl-xL蛋白、LDH、IPF、MMP-9水平,采用Pearson分析Bcl-xL蛋白、LDH、IPF、MMP-9与脓毒症病情程度的关系,Logistic回归方程分析脓毒症的相关影响因素,受试者工作特征曲线(receiver operating characteristic,ROC)分析Bcl-xL蛋白、LDH、IPF、MMP-9预测脓毒症的效能.结果观察组Bcl-xL蛋白、LDH、IPF、MMP-9较对照组显著升高(P<0.05);脓毒症手术时间长于非脓毒症,Bcl-xL蛋白、LDH、IPF、MMP-9水平高于非脓毒症(P<0.05);Bcl-xL蛋白、LDH、IPF、MMP-9水平与APACHEⅡ评分呈正相关(P<0.05);Logistic回归方程分析,结果显示,Bcl-xL蛋白、LDH、IPF、MMP-9高于均值者发生脓毒症的风险分别是低于均值者的1.174、2.883、2.562、1.948倍(P<0.05);经ROC分析Bcl-xL蛋白、LDH、IPF、MMP-9联合预测脓毒症的AUC为0.964,大于任一指标单独预测(P<0.05).结论EC术后胸腔感染患者Bcl-xL蛋白、LDH、IPF、MMP-9水平升高,且与病情进展关系密切,其预测EC术后胸腔感染继发脓毒症具有良好预测效能,便于指导临床完善防治方案.BACKGROUND Patients with esophageal cancer(EC) are prone to thoracic infection after surgery, but there is a lack of early prediction markers. Based on the fact that matrix metalloproteinase-9 (MMP-9), immature platelet ratio, macromolecular B lymphocytoma, and changes in lactate dehydrogenase levels are all related to infection, it was speculated that these changes may be candidate markers for clinical prediction of thoracic infection and sepsis.AIM To investigate the expression of B-cell lymphoma-extra large(Bcl-x L) protein, lactate dehydrogenase(LDH), immature platelet fraction(IPF), and MMP-9 in chest infections after EC surgery and their role in predicting sepsis.METHODS From February 2016 to October 2020, 187 patients with chest infection after EC surgery were selected as an observation group. The patients were divided into either a sepsis subgroup(16 cases) or a non-sepsis(171 cases) subgroup according to whether sepsis occurred. And 187 patients with no infection after EC surgery with matched clinical data during the same period were selected as a control group. The levels of Bcl-x L protein, LDH, IPF, and MMP-9 between the two groups and between patients with and without sepsis were compared. Pearson analysis was performed to investigate the relationship of Bcl-x L, LDH, IPF, and MMP-9 with the severity of sepsis. Logistic regression was used to analyze the factors related to sepsis. Receiver operating characteristic curve(ROC) was used to analyze the performance of Bcl-x L, LDH, IPF, and MMP-9 in predicting sepsis.RESULTS Bcl-x L, LDH, IPF, and MMP-9 in the observation group were significantly higher than those in the control group(P < 0.05). The operation time was longer and the levels of Bcl-x L, LDH, IPF, and MMP-9 were significantly higher in patients with sepsis than in those without(P < 0.05). The levels of Bcl-x L, LDH, IPF, and MMP-9 were positively correlated with APACHE II score(P < 0.05). Logistic regression analysis showed that the risk of sepsis was 1.174, 2.883, 2.562, and 1.948 times low

关 键 词：大分子B淋巴细胞瘤蛋白 乳酸脱氢酶 未成熟血小板比率 基质金属蛋白酶-9 脓毒症 

分 类 号：R735.1[医药卫生—肿瘤]