NLR、PCT、PGE2预测全麻腹部术后肺部感染的价值  

Value of NLR,PCT and PGE2 in predicting pulmonary infection after abdominal surgery under general anesthesia

作　　者：王瑞娟 杨艳[2] 景建闯 王献利 WANG Ruijuan;YANG Yan;JING Jianchuang;WANG Xianli(Department of Anesthesiology,Anyang Sixth People's Hospital,Anyang,Henan,China,455000;Department of Anesthesiology,Anyang District Hospital of Puyang City,Anyang,Henan,China,455000;Department of Anesthesiology,Anyang People's Hospital,Anyang,Henan,China,455000;Department of Stomatology,Anyang Sixth People's Hospital,Anyang,Henan,China,455000)

机构地区：[1]安阳市第六人民医院麻醉科,河南安阳455000 [2]濮阳市安阳地区医院麻醉科,河南安阳455000 [3]安阳市人民医院麻醉科,河南安阳455000 [4]安阳市第六人民医院口腔科,河南安阳455000

出　　处：《分子诊断与治疗杂志》2022年第5期824-827,共4页Journal of Molecular Diagnostics and Therapy

基　　金：安阳市科技攻关项目(2021C01NY046)。

摘　　要：目的探讨动态监测外周血中性粒细胞与淋巴细胞比值(NLR)、降钙素原(PCT)及前列腺素E2(PGE2)对全麻腹部手术患者术后肺部感染的预测价值。方法选取2019年1月至2021年3月在安阳市第六人民医院行全麻腹部手术的患者97例,分别于术后24、48和72 h,采用血细胞分析仪检测NLR,酶联免疫吸附试验检测PCT和PGE2水平。结果97例患者术后发生肺部感染21例(肺部感染组),发生比例为21.65%;肺部感染组和无肺部感染组患者性别、年龄等一般资料比较差异无统计学意义(P>0.05)。肺部感染组NLR、PCT和PGE2水平在术后24、48和72 h时水平均比无肺部感染者高,差异有统计学意义(P<0.05)。术后24、48和72 h NLR判断术后肺部感染的ROC曲线下面积分别为0.989、0.957和0.741(P<0.05);术后24、48和72 h PCT判断术后肺部感染的ROC曲线下面积分别为0.962、0.981和0.953(P<0.05);术后24、48和72 h PGE2判断术后肺部感染的ROC曲线下面积分别为0.860、0.742和0.610(P<0.05)。结论全麻腹部手术术后肺部感染患者外周血NLR、PCT、PGE2明显高于无肺部感染患者,在判断术后肺部感染中有一定预测价值。Objective To investigate the predictive value of dynamic monitoring of peripheral blood neutrophils and lymphocyte ratio(NLR),calcitonin(PCT) and prostaglandin E2(PGE2) in the postoperative pulmonary infection in patients undergoing general anesthesia abdominal surgery. Methods 97patients who underwent general anesthesia abdominal operation in Anyang Sixth People ’ s Hospital from January 2019 to March 2021 were selected,at 24h,48h and 48h after operation,Blood cell analyzer was used to detect NLR and enzyme-linked immunosorbent assay(ELISA)was used to detect PCT and PGE2 levels.Results Among the 97 patients,21 cases of pulmonary infection(pulmonary infection group)occurred after surgery,and the incidence rate was 21.65%. There was no significant difference in gender and age between the pulmonary infection group and the non pulmonary infection group(P>0.05). The levels of NLR,PCT and PGE2 in the pulmonary infection group were lower than those without pulmonary infection at 24,48 and 72 h after surgery,the difference was statistically significant(P<0.05). The area under the ROC curve of NLR at 24 h,48 h and 72 h after operation in diagnosis of postoperative pulmonary infection were 0.989,0.957 and0.741(P<0.05). The area under the ROC curve of PCT at 24 h,48 h and 72 h after operation in diagnosis of postoperative pulmonary infection were 0.962,0.981 and 0.953(P<0.05). The area under the ROC curve of PGE2 at 24 h,48 h and 72 h after operation in diagnosis of postoperative pulmonary infection were 0.860,0.742 and 0.610(P<0.05). Conclusion Peripheral blood NLR,PCT and PGE2 in patients with pulmonary infection after general anesthesia abdominal operation are significantly higher than those without pulmonary infection,which has a certain predictive value in the diagnosis of postoperative pulmonary infection.

关 键 词：中性粒细胞与淋巴细胞比值 降钙素原 前列腺素E2 全麻腹部手术 术后肺部感染 

分 类 号：R614[医药卫生—麻醉学]