结肠癌合并肠梗阻患者血清GABA水平与细菌移位间的关系分析  

Analysis of the relationship between serum GABA level and bacterial translocation in patients with colon cancer complicated with ileus

作　　者：邓文胜 DENG Wensheng(Department of Gastrointestinal Surgery,Pingxiang People′s Hospital,Pingxiang,Jiangxi 337000,China)

机构地区：[1]江西省萍乡市人民医院胃肠外科,江西萍乡337000

出　　处：《检验医学与临床》2023年第16期2339-2342,2347,共5页Laboratory Medicine and Clinic

基　　金：江西省卫生健康委员会科技计划项目(SKJP220218081)。

摘　　要：目的分析结肠癌合并肠梗阻患者血清γ-氨基丁酸(GABA)水平与细菌移位间的关系。方法选取2020年6月至2022年3月该院收治的结肠癌合并肠梗阻患者65例为观察组,另选取同期健康体检者65例为对照组。比较两组血清GABA水平,采用细菌培养明确观察组患者是否发生细菌移位,统计结肠癌合并肠梗阻患者细菌移位发生情况。对发生细菌移位的结肠癌合并肠梗阻患者进行单因素及多因素分析。采用受试者工作特征(ROC)曲线分析血清GABA水平评估结肠癌合并肠梗阻患者细菌移位的价值,并对血清GABA水平评估结肠癌合并肠梗阻患者细菌移位的决策曲线进行分析。结果观察组血清GABA水平低于对照组(P<0.05);65例结肠癌合并肠梗阻患者发生细菌移位的有26例,未发生细菌移位的有39例;术中肠管破裂及C反应蛋白、白细胞介素-6、降钙素原水平升高是结肠癌合并肠梗阻患者细菌移位的独立危险因素(P<0.05),GABA水平升高是结肠癌合并肠梗阻患者细菌移位的保护因素(P<0.05);血清GABA水平评估结肠癌合并肠梗阻患者发生细菌移位的曲线下面积为0.862,灵敏度为80.77%,特异度为79.49%,cut-off值为5.54μmol/L(P<0.05);GABA高表达的患者细菌移位发生率为21.88%(7/32),低于GABA低表达的患者的57.58%(19/33,P<0.05);当风险阈值为0~0.99时,净受益率>0,表明具有临床意义,且风险阈值越小,净受益率越大,净受益率最大为0.97。结论结肠癌合并肠梗阻患者血清GABA呈低水平表达,且当血清GABA<5.54μmol/L时,结肠癌合并肠梗阻患者细菌移位发生风险较高,GABA可作为评估细菌移位风险的辅助指标。Objective To analyze the relationship between serumγ-aminobutyric acid(GABA)level and bacterial translocation in patients with colon cancer complicated with ileus.Methods A total of 65 patients with colon cancer complicated with ileus treated in the hospital from June 2020 to March 2022 were selected as the observation group,and 65 healthy subjects during the same period were selected as the control group.The serum GABA levels of the two groups were compared,and bacterial culture was used to clearly observe whether bacterial translocation occurred in the group,and the incidence of bacterial translocation in patients with colon cancer complicated with ileus was counted.Univariate and multifactorial analysis were performed in patients with colon cancer complicated with ileus with bacterial translocation.Receiver operating characteristic(ROC)curve was used to analyze the value of serum GABA level in evaluating bacterial translocation in patients with colon cancer complicated with ileus,and the decision curve of serum GABA level in evaluating bacterial translocation in patients with colon cancer complicated with ileus was analyzed.Results The serum GABA level in the observation group was lower than that in the control group(P<0.05).In 65 patients with colon cancer complicated with ileus,26 cases had bacterial translocation,39 cases did not.Intraoperative intestinal tube rupture and increased levels of C-reactive protein,interleukin-6 and procalcitonin were independent risk factors for bacterial translocation in patients with colon cancer complicated with ileus(P<0.05),and increased level of GABA was protective factors for bacterial translocation in patients with colon cancer complicated with ileus(P<0.05).The area under the curve was 0.862,the sensitivity was 80.77%,the specificity was 79.49%,and the cut-off value was 5.54μmol/L(P<0.05).The incidence of bacterial translocation in patients with high GABA expression was 21.88%(7/32),which was lower than that in patients with low GABA expression(57.58%,19/33,P<0.05).W

关 键 词：结肠癌 肠梗阻 Γ-氨基丁酸 细菌移位 

分 类 号：R446.5[医药卫生—诊断学]