老年患者全身麻醉手术后肺部细菌感染与血清IFN-γ、sCD163水平关系分析  

The relationship between serum IFN-γ,sCD163 and pulmonary bacterial infection in elderly patients after general anesthesia surgery

作　　者：梁桂金 来伟 双峰 胡平 郑增露 蒋玉婷 孟海兵 LIANG Guijin;LAI Wei;SHUANG Feng;HU Ping;ZHENG Zenglu;JIANG Yuting;MENG Haibing(Department of Anesthesiology,908 th Hospital of Joint Logistics Security Forces,Nanchang 330001,China;Department of Orthopedics,908 th Hospital of Joint Logistics Security Forces)

机构地区：[1]联勤保障部队第九〇八医院麻醉科,江西南昌330001 [2]联勤保障部队第九〇八医院骨科

出　　处：《中国病原生物学杂志》2023年第10期1185-1189,共5页Journal of Pathogen Biology

基　　金：江西省卫生健康委科技计划项目(No.SKJP220226359)。

摘　　要：目的 探究血清干扰素(IFN-γ)、可溶性血红蛋白清道夫受体(sCD163)与老年患者全身麻醉手术后肺部细菌感染的关系。方法 选取2021年5月-2022年5月在本院收治的180例全身麻醉手术的老年患者作为研究对象,根据全身麻醉手术后情况,将术后72 h内发生肺部感染的患者作为观察组(40例),术后无肺部感染患者为对照组(140例),比较两组的一般资料、血清IFN-γ、sCD163水平,受试者工作特征曲线(ROC)分析血清IFN-γ、sCD163水平对全身麻醉手术后老年患者肺部感染的评估价值。多因素Logistic回归分析影响全身麻醉手术后肺部感染的因素。结果 与对照组相比,观察组患者的手术时间(219.31±46.72 min vs 202.12±43.55 min)、术中出血量(175.74±33.25 mL vs 161.82±31.29 mL)较高,差异有统计学意义(P<0.05)。观察组患者血清IFN-γ(2.68±0.81 pg/mL vs 1.94±0.55 pg/mL)、sCD163(375.42±46.45 mg/L vs 321.27±41.29 mg/L)水平比对照组高(P<0.05)。轻度组、中度组和重度组三组患者血清IFN-γ(2.18±0.35 pg/mL vs 2.79±0.63 pg/mL vs 3.45±0.46 pg/mL)、sCD163水平(339.98±43.25 mg/L vs 378.17±47.23 mg/L vs 438.08±52.16 mg/L)差异有统计学意义(P<0.05),随着病情的加重,患者血清IFN-γ、sCD163水平逐渐升高(P<0.05)。ROC曲线分析显示,IFN-γ、sCD163辅助诊断老年患者全麻术后肺部感染的曲线下面积(AUC)是0.818(95%CI:0.746~0.891)、0.761(95%CI:0.669~0.852),二者联合诊断的AUC为0.911(95%CI:0.857~0.965),均优于各自单独检测(Z=2.030、2.812,P<0.05)。多因素Logistic回归分析显示,IFN-γ、sCD163是影响全麻术后发生肺部感染的危险因素(P<0.05)。结论 血清IFN-γ、sCD163与老年患者全麻手术后肺部细菌感染严重程度相关,可为评估患者病情提供参考。Objective To investigate the relationship between serum interferon(IFN-γ),soluble hemoglobin scavenger receptor(sCD163),and pulmonary bacterial infection in elderly patients after general anesthesia surgery.Methods A total of 180elderly patients undergoing general anesthesia surgery admitted to our hospital from May 2021to May 2022 were regarded as the study subjects,according to the postoperative situation of general anesthesia surgery,patients with pulmonary infection within 72hours after surgery were selected as the observation group(40cases),and patients without pulmonary infection after surgery were selected as the control group(140cases),the general information,serum IFN-γ,and sCD163levels of the two groups were compared.Receiver operating characteristic curve(ROC)was applied to ana-lyze the evaluation value of serum IFN-γand sCD163levels for pulmonary infection in elderly patients after general anes-thesia surgery.Multivariate Logistic regression was applied to analyze the factors affecting pulmonary infection after gen-eral anesthesia surgery.Results Compared with the control group,the operation time(219.31±46.72min vs 202.12±43.55min)and intraoperative blood loss(175.74±33.25mL vs 161.82±31.29mL)of the observation group were high-er,and the difference was statistically significant(P<0.05).The levels of serum IFN-γ(2.68±0.81pg/mL vs 1.94±0.55pg/mL)and sCD163(375.42±46.45mg/L vs 321.27±41.29mg/L)in the observation group were higher than those n the control group(P<0.05).The levels of serum IFN-γ(2.18±0.35pg/mL vs 2.79±0.63pg/mL vs 3.45±0.46pg/mL)and sCD163(339.98±43.25mg/L vs 378.17±47.23mg/L vs 438.08±52.16mg/L)in the mild group,moderate group and severe group were significantly different(P<0.05).The serum levels of IFN-γand sCD163in patients in-creased gradually(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of IFN-γand sCD163in the diagnosis of pulmonary infection after general anesthesia in elderly patients was 0.818(95%CI:0.746-0.891)and 0.761(95%CI:0.669-0.85

关 键 词：全身麻醉 肺部细菌感染 干扰素 可溶性血红蛋白清道夫受体 

分 类 号：R378[医药卫生—病原生物学]