乳腺癌化疗后粒细胞减少伴发热患者感染影响因素及PCT与NLR和PLR预测感染的价值  

Influencing factors of infection and the predictive value of PCT, NLR and PLR in patients with febrile neutropenia after breast cancer chemotherapy

作　　者：王红丽[1] 黄国胜[2] 亚国伟[1] 刘云鹤[1] 杨敬端[3] WANG Hong-li;HUANG Guo-sheng;YA Guo-wei;LIU Yun-he;YANG Jing-duan(The First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院肿瘤内科,河南南阳473000 [2]南阳医学高等专科学校第一附属医院普胸外科,河南南阳473000 [3]南阳医学高等专科学校第一附属医院消化内科,河南南阳473000

出　　处：《中华医院感染学杂志》2022年第19期2983-2986,共4页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划联合共建基金资助项目(LHGJ20191461)。

摘　　要：目的 探讨乳腺癌化疗后粒细胞减少伴发热(FN)患者感染影响因素及降钙素原(PCT)、中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)预测感染的价值。方法 选取2018年3月-2020年6月南阳医学高等专科学校第一附属医院收治的172例乳腺癌化疗后FN患者为研究对象,根据患者是否合并感染分为感染组和非感染组。检测患者外周血PCT、NLR和PLR水平,分析患者资料,归纳乳腺癌化疗后FN患者感染的影响因素,采用受试者工作特征(ROC)曲线评估PCT、NLR、PLR对乳腺癌化疗后FN患者感染的预测价值。结果 172例乳腺癌化疗后FN患者中,感染42例,感染率为24.42%;感染组PCT、NLR及PLR高于非感染组(P<0.05);Logistic回归分析结果显示,PCT、NLR、PLR及化疗周期是乳腺癌化疗后FN患者感染的影响因素(P<0.05);PCT、NLR及PLR用于预测乳腺癌化疗后FN患者感染发生的曲线下面积(AUC)分别为0.865、0.766、0.755;将3项指标联合用于乳腺癌化疗后FN患者感染发生的预测,其AUC高达0.917,高于单一指标检测(P<0.05)。结论 乳腺癌化疗后FN合并感染患者外周血PCT、NLR和PLR升高,外周血PCT、NLR和PLR可在一定程度上预测患者感染的发生。OBJECTIVE To explore the influencing factors of infection and the predictive value of procalcitonin(PCT), neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte ratio(PLR) in patients with febrile neutropenia(FN) after breast cancer chemotherapy. METHODS A total of 172 patients with FN after breast cancer chemotherapy admitted to the First Affiliated Hospital of Nanyang Medical College were enrolled as the research subjects between Mar. 2018 and Jun. 2020. According to presence or absence of infection, they were divided into infection group and non-infection group. The levels of peripheral blood PCT, NLR and PLR were detected. The data of patients were analyzed. The influencing factors of infection were summarized. The predictive value of PCT, NLR and PLR for infection was evaluated by receiver operating characteristic(ROC) curves. RESULTS In the 172 FN patients after breast cancer chemotherapy, there were 42 cases(24.42%) with infection. PCT, NLR and PLR in infection group were higher than those in non-infection group(P<0.05). The results of Logistic regression analysis showed that PCT, NLR, PLR and chemotherapy cycle were influencing factors of infection(P<0.05). The area under the curve(AUC) values of PCT, NLR, PLR and their combination for predicting infection were 0.865, 0.766, 0.755 and 0.917, respectively. AUC of combined detection was greater than that of the detection of single index(P<0.05). CONCLUSION The levels of peripheral blood PCT, NLR and PLR are increased in patients with FN and infection after breast cancer chemotherapy. The three can predict the occurrence of infection to some extent.

关 键 词：乳腺癌化疗 粒细胞减少伴发热 感染 影响因素 降钙素原 中性粒细胞/淋巴细胞比值 血小板/淋巴细胞比值 预测价值 

分 类 号：R737.9[医药卫生—肿瘤]