血清PCT、TIM-4、sTREM-1联合检测对胃肠手术后肺部感染的预测价值  

Predictive value of combined detection of serum PCT,TIM-4 and sTREM-1 for pulmonary infection after gastrointestinal surgery

作　　者：邓波 韩琦[1] 朱必胜 孟勇 DENG Bo;HAN Qi;ZHU Bi-sheng;MENG Yong(Department of Oncology,First Affiliated Hospital of Hubei University of Science and Technology/Xianning Central Hospital,Xianning Hubei 437100,China;Department of Gastrointestinal Surgery,First Affiliated Hospital of Hubei University of Science and Technology/Xianning Central Hospital,Xianning Hubei 437100,China)

机构地区：[1]湖北科技学院附属第一医院/咸宁市中心医院肿瘤科,湖北咸宁437100 [2]湖北科技学院附属第一医院/咸宁市中心医院胃肠外科,湖北咸宁437100

出　　处：《局解手术学杂志》2023年第6期540-543,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：咸宁市中心医院院级科研项目(2021XYB021)。

摘　　要：目的探讨血清降钙素原(PCT)、T细胞免疫球蛋白及粘蛋白域蛋白-4(TIM-4)、可溶性髓样细胞触发受体-1(sTREM-1)联合检测对胃肠手术后肺部感染的诊断价值。方法选择在本院进行胃肠手术后发生肺部感染的67例患者作为观察对象(感染组),根据治疗结局分为治疗好转组(42例)与治疗未好转组(25例);选择同期进行胃肠手术后无感染患者70例作为无感染组。分别于胃肠手术后24 h(T1)、出现肺部感染时(T2)、肺部感染后48 h(T3)检测患者血清PCT、TIM-4、sTREM-1水平;受试者工作特征(ROC)曲线分析血清PCT、TIM-4、sTREM-1对胃肠手术后肺部感染的诊断价值。结果无感染组与感染组患者年龄、性别、BMI、吸烟史、高血压史、冠心病史、合并肺气肿、合并慢性阻塞性肺疾病(COPD)及手术方式比较差异无统计学意义(P>0.05);2组患者卧床时间与留置胃管时间比较差异有统计学意义(P<0.05);感染组患者术后24 h血清PCT、TIM-4、sTREM-1水平明显高于无感染组(P<0.05);血清PCT、TIM-4、sTREM-1联合诊断胃肠手术后肺部感染的敏感度为92.54%,特异度为81.43%,曲线下面积(AUC)为0.947,诊断效能高于单项指标检测;在T1、T2、T3时点,治疗未好转组患者血清PCT、TIM-4、sTREM-1水平显著高于治疗好转组患者(P<0.05)。结论胃肠手术后肺部感染患者血清PCT、TIM-4、sTREM-1水平升高,早期检测PCT、TIM-4、sTREM-1水平对胃肠手术后肺部感染的诊断及疗效评估有一定价值。Objective To investigate the diagnostic value of combined detection of serum procalcitonin(PCT),T cell immunoglobulin and mucin domain protein-4(TIM-4)and soluble triggering receptor expressed on myeloid cells-1(sTREM-1)for pulmonary infection after gastrointestinal surgery.Methods Sixty-seven patients who developed pulmonary infection after gastrointestinal surgery in our hospital were regarded as observation objects(infection group),and they were divided into the treatment-improved group(42 cases)and the treatment-unimproved group(25 cases)according to the treatment outcome.Seventy patients without infection who underwent gastrointestinal surgery were regarded as the non-infection group.The levels of serum PCT,TIM-4 and sTREM-1 were detected 24 hours after gastrointestinal surgery(T1),when pulmonary infection occurred(T2),and 48 hours after pulmonary infection(T3).Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum PCT,TIM-4 and sTREM-1 for pulmonary infection after gastrointestinal surgery.Results There was no statistics difference in the age,gender,BMI,smoking history,hypertension history,coronary heart disease history,combined with emphysema,combined with chronic obstructive pulmonary disease(COPD),and surgical methods between the noninfection group and the infection group(P>0.05).There were statistics differences in the bed rest time and the time of indwelling gastric tube between the infection group and the non-infection group(P<0.05).The levels of serum PCT,TIM-4 and sTREM-1 in the infection group 24 hours after operation were significantly higher than those in the non-infection group(P<0.05).The sensitivity of the combination of serum PCT,TIM-4 and sTREM-1 in diagnosing pulmonary infection after gastrointestinal surgery was 92.54%,the specificity was 81.43%,and the area under the curve(AUC)was 0.947,and the diagnostic efficiency was higher than that of single index detection.The levels of serum PCT,TIM-4,and sTREM-1 of patients at T1,T2,and T3 time points in the

关 键 词：胃肠手术 降钙素原 T细胞免疫球蛋白及粘蛋白域蛋白-4 可溶性髓样细胞触发受体-1 肺部感染 

分 类 号：R735[医药卫生—肿瘤]