胸腔镜肺癌根治术后肺部感染对外周血炎性细胞因子变化的影响  

Effect of pulmonary infection after radical thoracoscopic surgeryin patients with Non-Small Cell Lung Cancer on changes of inflammatory cytokines in peripheral blood

作　　者：何锋[1] 刘宁[1] 陈新富[1] 王小英 陈树兴[1] 林铿强 HE Feng;LIU Ning;CHEN Xin-fu(Department of Thoracic Surgery,Fuzhou Pulmonary Hospital,Affiliated Teaching Hospital of Fujian Medical University,Fuzhou 350007,China)

机构地区：[1]福建医科大学附属教学医院,福州肺科医院胸外科,福建福州350007

出　　处：《吉林医学》2021年第10期2368-2373,共6页Jilin Medical Journal

基　　金：福州市级科技计划项目:社会发展项目-医疗项目[项目编号:2020-WS-117];福州市2019年临床重点专科建设项目:临床重点专科[项目编号:201912003]。

摘　　要：目的:探讨非小细胞肺癌患者行胸腔镜肺癌根治术后发生肺部感染对外周血炎性细胞因子(IL-6、IL-8、IL-10)变化的影响及相关性。方法:选取行胸腔镜肺癌根治术的102例非小细胞肺癌(NSCLC)患者,按术后有无肺部感染发生分为感染组(49例)和观察组(53例),于术前、术后2 h、术后第1天、术后第3天、术后第5天应用酶联免疫吸附试验(ELISA)法检测血清中炎性细胞因子白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)浓度变化。结果:男性、吸烟、手术时间长的NSCLC患者术后肺部感染发生几率高于女性、非吸烟、手术时间短者,差异有统计学意义(P<0.05);病理分期晚、有淋巴结转移、浸润性肺癌患者肺部感染发生几率高于早期肺癌、无淋巴结转移、原位癌、微浸润性肺癌患者,差异有统计学意义(P<0.05)。两组患者术后血清PCT、CRP、IL-6、IL-8、IL-10水平高于术前,差异有统计学意义(P<0.05)。术后2 h感染组血清中IL-10水平最先高于观察组(P=0.001),差异早于其他指标出现;术后感染组IL-6、IL-8、IL-10水平高于观察组,差异有统计学意义(P<0.05);两组患者PCT、IL-6、IL-8、IL-10于术后第1天达峰值,CRP于术后第3天达峰值;术后第5天,两组患者上述指标回落,其中CRP、IL-6、IL-8、IL-10两组间比较差异存在统计学意义(P<0.05),PCT两组间比较,差异无统计学意义(P>0.05)。结论:外周血炎性细胞因子IL-6、IL-8、IL-10变化和胸腔镜肺癌根治术后肺部感染发生密切相关,是早期诊断肺部感染的敏感辅助指标。Objective To investigate the effect and correlation of pulmonary infection after radical thoracoscopic surgeryin patients with Non-Small Cell Lung Cancer on the changes of inflammatory cytokines(interleukin-6,interleukin-8,interleukin-10)in peripheral blood.Method One hundred and two patients with NSCLC were assigned to receive radical thoracoscopic surgery and divided into infection group(49 cases)and observation group(53 cases)according to whether there was pulmonary infection after operation.Serum samples were collected before operation and 2 hours,1 day,3 days,5 days after operation.The changes of serum inflammatory cytokines(IL-6、IL-8、IL-10)were measured by double-antibody sandwich ELISA,Comparison of CRP and PCT in the same period.Results The incidence of postoperative pulmonary infection in male,smoking and long operation time NSCLC patients was higher than that in female,non-smoking and short operation time(P<0.05).The incidence of pulmonary infection in patients with late pathological stage,lymph node metastasis and invasive lung cancer was higher than that in patients with early lung cancer,no lymph node metastasis,AISand MIA(P<0.05).The levels of PCT,CRP,IL-6,IL-8 and IL-10 in serum after operation were higher than those before operation in two groups(P<0.05).At 2 h after operation,the level of IL-10 in the infection group was first higher than that in the observation group(P=0.001),differences earlier than other test indicators.The levels of IL-6,IL-8 and IL-10 in the infection group were higher than those in the observation group after operation(P<0.05).The levels of PCT,IL-6,IL-8 and IL-10 reached the peak at the first day after operation and the levels of CRP reached the peak at the third day after operation.On the 5th day after operation,the above indexes in the two groups decreased,and there were statistical differences in CRP,IL-6,IL-8 and IL-10 between the two groups(P<0.05),while there was no statistical difference in PCT between the two groups(P>0.05).Conclusion Changes of inflammatory cy

关 键 词：非小细胞肺癌 胸腔镜 根治术 炎性细胞因子 肺部感染 

分 类 号：R734.2[医药卫生—肿瘤]