腹部外科术后腹腔感染外周血IL-6及中性粒细胞CD64和CD11b表达水平  

Expression of peripheral blood IL-6,neutrophils CD64 and CD11b in patients with abdominal infection after abdominal surgery

作　　者：辛亮 韩敏[2] 王鸿康 何鑫[1] 金鑫 李鸣 XIN Liang;HAN Min;WANG Hong-kang;HE Xin;JIN Xin;LI Ming(Wuhan Fourth Hospital(Puai Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology),Wuhan,Hubei 430034,China;不详)

机构地区：[1]武汉市第四医院(华中科技大学同济医学院附属普爱医院)外科,湖北武汉430034 [2]华中科技大学同济医学院附属武汉儿童医院外科,湖北武汉430015

出　　处：《中华医院感染学杂志》2021年第21期3297-3301,共5页Chinese Journal of Nosocomiology

基　　金：武汉市卫生计划委员会基金资助项目(WZ15D12)。

摘　　要：目的探讨腹部外科术后腹腔感染患者外周血白细胞介素-6(IL-6)、中性粒细胞CD64、CD11b表达水平及意义。方法选取2018年3月-2020年10月武汉市第四医院收治行腹部外科手术治疗术后腹腔感染患者64例为感染组,同期未发生腹腔感染患者40例为对照组。多因素Logistic回归分析术后腹腔感染的危险因素,并分别检测不同时间点IL-6、中性粒细胞CD64、CD11b水平,受试者工作特征曲线(ROC)评估外周血IL-6、中性粒细胞CD64、CD11b水平诊断术后腹腔感染的效能。结果单因素及Logistic回归分析显示,合并糖尿病、开腹手术、有术前放化疗、手术时间为腹部外科术后腹腔感染的独立危险因素(P<0.05);术后12、24、72 h,感染组患者IL-6、CD64和CD11b表达水平与术前比较均上升(P<0.05),且感染组IL-6、CD64和CD11b表达水平均高于对照组(P<0.05);ROC曲线显示,术后12 h外周血IL-6、中性粒细胞CD64和CD11b表达水平诊断腹部外科术后腹腔感染的截点分别为21.35 pg/ml、59.37平均荧光强度(MFI)、486.26 MFI,AUC分别为0.886、0.847、0.889,三者联合预测的AUC为0.943,高于三者单独预测AUC值(P<0.05)。结论影响腹部外科术后腹腔感染的因素较多,临床中应重点关注合并糖尿病、开腹手术、术前放化疗以及手术时间长的患者,术后12 h外周血IL-6、中性粒细胞表型CD64和CD11b表达水平对患者腹腔感染具有较高的诊断价值。OBJECTIVE To explore the expression levels of peripheral blood interleukin-6(IL-6), neutrophils CD64 and CD11 b in patients with abdominal infection after abdominal surgery and analyze the significance. METHODS A total of 64 patients who received abdominal surgery and had postoperative abdominal infection in Wuhan Fourth Hospital from Mar 2018 to Oct 2020 were assigned as the infection group, meanwhile, 40 patients who did not have abdominal infection were set as the control group. Multivariate logistic regression analysis was performed for risk factors for the postoperative abdominal infection, the levels of IL-6, neutrophils CD64 and CD11 b were detected at different time points, and the efficiencies of peripheral blood IL-6, neutrophils CD64 and CD11 b in diagnosis of postoperative abdominal infection were evaluated by receiver operating characteristics(ROC) curve. RESULTS Univariate and logistic regression analysis showed that complication with diabetes mellitus, laparotomy, preoperative chemoradiotherapy and operation duration were independent risk factors for the postoperative abdominal infection(P<0.05). The expression levels of IL-6, CD64 and CD11 b of the infection group were significantly higher after surgery for 12, 24 and 72 hours than before the surgery(P<0.05), and the expression levels of IL-6, CD64 and CD11 b of the infection group were significantly higher than those of the control group(P<0.05). ROC curve analysis indicated that the cutoff values of peripheral blood IL-6, neutrophils CD64 and CD11 b 12 hours after the surgery were respectively 21.35 pg/ml, 59.37 mean fluorescence intensity(MFI) and 486.26 MFI in diagnosis of the postoperative abdominal infection in the patients undergoing abdominal surgery, the AUCs were respectively 0.886, 0.847 and 0.889, and the AUC of the joint detection of the three indexes was 0.943, significantly higher than that of the detection of single index(P<0.05). CONCLUSION There are a variety of factors for postoperative abdominal infection in the abdominal surge

关 键 词：腹腔感染 白细胞介素-6 中性粒细胞CD64 CD11B 

分 类 号：R619.3[医药卫生—外科学]