晚期非小细胞肺癌化疗合并院内肺部感染的影响因素及白蛋白球蛋白比值的早期预测价值分析  

Analysis of Factors Influencing Nosocomial Lung Infection Combined with Chemotherapy in Advanced Non-small Cell Lung Cancer and the Early Predictive Value of Albumin-globulin Ratio

作　　者：姚宁 Yao Ning(Department of Intensive Care Medicine,Henan Provincial Staff Hospital,Zhengzhou,Henan,450000,China)

机构地区：[1]河南省职工医院重症医学科,河南郑州450000

出　　处：《黑龙江医学》2023年第15期1810-1813,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨晚期非小细胞肺癌(NSCLC)化疗合并院内肺部感染的影响因素及白蛋白球蛋白比值的早期预测价值,旨在为后续同类患者的院内肺部感染预防策略的制定提供参考指标。方法:选取2019年3月-2021年3月河南省职工医院接受化疗的Ⅳ期NSCLC患者作为研究对象,根据化疗期间是否新发肺部感染将所有入组患者分为院内肺部感染组(n=50)、非院内肺部感染组(n=118)。采用单因素、logistics回归模型分析晚期NSCLC患者化疗合并院内肺部感染的危险因素,采用受试者工作特征(ROC)曲线分析白蛋白球蛋白比值(AGR)对晚期NSCLC患者化疗合并院内肺部感染的预测价值。结果:两组患者年龄、糖尿病、同期放疗、侵入性操作、化疗前AGR的分布差异有统计学意义(χ^(2)=4.100、6.267、4.245、4.202,t=3.970,P<0.05)。logistics回归分析发现:年龄≥70周岁、合并糖尿病、同期放疗、期间侵入性操作、化疗前AGR较低是NSCLC化疗合并院内肺部感染的独立危险因素(P<0.05)。ROC曲线显示,化疗前AGR预测NSCLC化疗期间院内肺部感染发生的最佳截断值为1.49,AUC为0.826[95%CI 0.763~0.890],对应的灵敏度、特异度分别为72.88%、70.00%。结论:化疗前AGR异常降低是晚期NSCLC患者化疗期间合并院内肺部感染的危险因素,且对该事件发生具有早期预警价值。Objective:To investigate the influencing factors and the early predictive value of albumin-globulin ratio of nosoco-mial lung infection in advanced non-small cell lung cancer(NSCLC)chemotherapy combined with nosocomial lung infection,with the aim of providing reference indicators for the development of nosocomial lung infection prevention strategies in subsequent simi-lar patients.Methods:Patients with stage IV NSCLC receiving chemotherapy in hospitals from March 2019 to March 2021 were se-lected for the study,and all enrolled patients were divided into nosocomial lung infection group(n=50)and non-nosocomial lung in-fection group(n=118)according to whether new lung infection occurred during chemotherapy.A univariate,logistic regression model was used to analyze the risk factors for chemotherapy combined with nosocomial lung infection in patients with advanced NSCLC.Subject work characteristic(ROC)curves were used to analyze the predictive value of albumin-globulin ratio(AGR)for chemothera-py-combined nosocomial lung infections in patients with advanced NSCLC.Results:There was a statistically significant difference in the distribution of age,diabetes,concurrent radiotherapy,invasive manipulation,and pre-chemotherapy AGR between the two groups(χ^(2)=4.100,6.267,4.245,4.202,t=3.970,P<0.05).Logistics regression analysis revealed that age≥70 years,comorbid dia-betes,concurrent radiotherapy,invasive operations during the period,and low AGR before chemotherapy were independent risk fac-tors for nosocomial pulmonary infection in combination with chemotherapy for NSCLC(P<0.05).The ROC curve showed that the best cut-off value for pre-chemotherapy AGR to predict the occurrence of nosocomial lung infection during chemotherapy for NSCLC was 1.49,with an AUC of 0.826(95%CI 0.763-0.890),corresponding to a sensitivity and specificity of 72.88%and 70.00%,respectively.Conclusion:Abnormally low pre-chemotherapy AGR is a risk factor for nosocomial lung infection during chemotherapy in patients with advanced NSCLC and has early wa

关 键 词：晚期非小细胞肺癌 院内肺部感染 白蛋白球蛋白比值 预测 

分 类 号：R734.2[医药卫生—肿瘤]