血清炎性因子PCT、IL-6、CRP联合检测对老年肝功能失代偿期肝癌患者发生感染的预测效能分析  

Predictive effect of combined detection of serum inflammatory factors PCT,IL-6 and CRP on infection of elderly patients with liver cancer at decompensated stage

作　　者：段艳鸽 王玉霞 刘彩霞 Duan Yan-ge;Wang Yu-xia;Liu Cai-xia(Department of Laboratory,Kaifeng Second Hospital of Traditional Chinese Medicine,Kaifeng 475000,Henan,China)

机构地区：[1]开封市第二中医院检验科,河南开封475000

出　　处：《四川生理科学杂志》2023年第6期980-983,1015,共5页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨血清炎性因子降钙素原(Procalcitonin,PCT)、白细胞介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)联合检测对老年肝功能失代偿期肝癌患者发生感染的预测效能。方法:选取我院2019年9月至2021年9月就诊的158例肝功能失代偿期肝癌患者作为研究组,另选取同期79名健康体检者作为对照组。入院时,抽取患者外周静脉血,全自动微生物分析仪分离并鉴定病原菌感染和分布情况,电化学发光法测定患者血清PCT水平;免疫比浊法测定患者血清CRP水平,酶联免疫吸附法测定患者血清IL-6水平,比较研究组、对照组及研究组中感染患者、未感染患者血清PCT、IL-6、CRP水平,Logistic回归方程分析上述指标与发生感染的关系,受试者工作特征曲线(Receiver operating characteristic,ROC)及曲线下面积(Area under the ROC curve,AUC)分析其对发生感染的预测价值。结果:入院时,研究组血清PCT、IL-6、CRP水平高于对照组(P<0.05);研究组中共43例发生感染,感染病原菌以金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌为主,分别占22.92%、27.08%、18.75%;研究组中感染患者血清PCT、IL-6、CRP水平高于未感染患者(P<0.05);Logistic回归分析显示,入院时血清PCT、IL-6、CRP水平与失代偿期肝癌患者发生感染具有显著相关性(OR=12.346、8.682、10.554,P<0.05);入院时血清PCT、IL-6、CRP水平对失代偿期肝癌患者发生感染的预测AUC分别为0.872、0.789、0.848,联合预测AUC为0.923,联合预测AUC大于单一指标。结论:血清PCT、IL-6、CRP水平变化与老年肝功能失代偿期肝癌患者发生感染密切相关,临床可通过联合检测血清PCT、IL-6、CRP水平可早期预测失代偿期肝癌是否发生感染,以针对性制定干预措施。Objective:To investigate the predictive effect of combined detection of serum procalcitonin(PCT),interleukin-6(IL-6),and C-reactive protein(CRP)levels on infection of elderly patients with liver cancer at the decompensation stage.Methods:A total of 158 elderly patients with liver cancer at the decompensation stage in our hospital from September 2019 to September 2021 were selected as the study group,and 79 healthy people in the same period were selected as the control group.On admission,the peripheral venous blood of the patients was collected and the infection and distribution of pathogenic bacteria were separated and identified by automatic microbial analyzer,and the serum level of PCT was measured by electrochemiluminescence method,serum level of CRP was measured by immunoturbidimetry,and serum level of IL-6 was measured by enzyme-linked immunosorbent assay.The serum levels of PCT,IL-6,CRP in infected patients and uninfected patients in the study group,the control group and the study group were compared.Logistic regression equation was used to analyze the correlation of the above indicators with infected patients,and receiver operating characteristic(ROC)and area under the ROC curve(AUC)were used to analyze their predictive value for infected patients.Results:The serum levels of PCT,IL-6 and CRP in the study group were higher than those in the control group at admission(P<0.05).There were 43 cases of infected patients in the study group.The main pathogens of infection were Staphylococcus aureus,Escherichia coli and Klebsiella pneumoniae,accounting for 22.92%,27.08%and 18.75%,respectively.The serum levels of PCT,IL-6 and CRP in the infected patients were higher than those in uninfected patients in the study group(P<0.05).Logistic regression analysis showed that the serum levels of PCT,IL-6,CRP at admission were significantly correlated with the infection of patients with liver cancer at decompensated stage(OR=12.346,8.682,10.554,P<0.05).The predictive AUC of serum levels of PCT,IL-6 and CRP in infected patients

关 键 词：肝功能失代偿期 肝癌 炎性因子 

分 类 号：R735.7[医药卫生—肿瘤]