老年肺癌患者术后血和肽素、IGF-I、Ⅳ-C与肺部感染及感染转归的关系  

Relationship between postoperative blood copeptin, IGF-I, and Ⅳ-C levels in elderly patients with lung cancer and their concurrent pulmonary infection and the outcome of infection

作　　者：朱秀英[1] 朱林文 张旭红 李旎 施丽红 ZHU Xiu-ying;ZHU Lin-wen;ZHANG Xu-hong;LI Ni;SHI Li-hong(Li Huili Hospital,Ningbo Medical Center,Ningbo,Zhejiang 315040,China;不详)

机构地区：[1]宁波市医疗中心李惠利医院心胸外科,浙江宁波315040 [2]宁波市医疗中心李惠利医院心胸外科一,浙江宁波315040 [3]慈溪市人民医院医疗健康集团胸外科,浙江慈溪315300

出　　处：《中华医院感染学杂志》2022年第16期2487-2490,共4页Chinese Journal of Nosocomiology

基　　金：宁波市自然科学基金资助项目(202003N4269)。

摘　　要：目的 探究老年肺癌患者术后血和肽素、胰岛素样生长因子-1(IGF-1)、Ⅳ型胶原(Ⅳ-C)水平与其并发肺部感染及感染转归关系。方法 选取2019年3月-2021年3月医院120例老年肺癌患者作为研究对象,根据术后是否发生肺部感染分为感染组25例、非感染组95例,检测两组术后第1、3、5、7天和肽素、IGF-I、Ⅳ-C水平。结果 术后第3、5、7天,感染组和肽素、IGF-I、Ⅳ-C水平均高于非感染组(P<0.05);老年肺癌并发肺部感染患者术后第5天CPIS评分为(7.78±0.65)分,与和肽素、IGF-I、Ⅳ-C水平呈正相关关系(P<0.05);绘制ROC曲线显示,术后第5天和肽素、IGF-I、Ⅳ-C水平联合诊断老年肺癌患者术后并发肺部感染AUC最大,>0.9,具有良好诊断效能;随访6个月,术后第5天和肽素、IGF-I、Ⅳ-C水平联合诊断阳性患者死亡率高于阴性患者(P<0.05)。结论 老年肺癌并发肺部感染患者和肽素、IGF-I、Ⅳ-C水平明显升高,三种指标与患者感染程度及转归具有一定相关性,临床监测其水平,有助于早期感染控制,改善患者预后。OBJECTIVE To investigate the relationship between postoperative blood and peptide, insulin-like growth factor-1(IGF-1) and type IV collagen(IV-C) levels and their concurrent pulmonary infections and infection outcome in elderly lung cancer patients. METHODS A total of 120 elderly patients with lung cancer in our hospital from Mar 2019 to Mar 2021 were recruited and divided into the infection group(25 cases) and non-infection group(95 cases) according to whether pulmonary infection occurred after operation. IGF-I and IV-C levels in both groups were detected on postoperative day 1, 3, 5 and 7. RESULTS On postoperative days 3, 5 and 7, the levels of hepcidin, IGF-I and IV-C were significantly higher in the infected group than those in the non-infected group(P<0.05);the CPIS score on postoperative day 5 in elderly patients with lung cancer complicated with lung infection was(7.78±0.65), which was positively correlated with the levels of hepcidin, IGF-I and IV-C(P<0.05);ROC curve showed that the AUC of the combined detection of hepcidin, IGF-I and IV-C on postoperative day 5 was the largest, >0.9, which showed good diagnostic efficacy. The mortality rate of patients with positive combined diagnosis of peptide, IGF-I, and IV-C levels on postoperative day 5 were significantly higher than that of negative patients after 6-month follow-up(P<0.05). CONCLUSION The levels of copeptin, IGF-I, and IV-C in elderly patients with lung cancer complicated by pulmonary infection significantly increased. The three indicators have a certain correlation with the degree of infection and outcome of the patients. Clinical monitoring of the above indexes can help early infection control and improve the prognosis of patients.

关 键 词：肺癌 老年 肺部感染 和肽素 胰岛素样生长因子-1 Ⅳ型胶原 感染转归 

分 类 号：R563.1[医药卫生—呼吸系统]