头颈部肿瘤放疗期间肺部感染危险因素及D-D和PCT与CRP对其预测价值  

Risk factors for pulmonary infection during radiotherapy for head and neck tumors and the predictive value of the D-D,PCT and CRP levels

作　　者：刘大响[1] 王令焕[1] 徐梅[1] 闫春花[1] 王秀珍[1] 高超[1] 张兰[1] LIU Da-xiang;WANG Ling-huan;XU Mei;YAN Chun-hua;WANG Xiu-zhen;GAO Chao;ZHANG Lan(The Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei 050035,China)

机构地区：[1]河北医科大学第四医院耳鼻咽喉头颈外科,河北石家庄050035

出　　处：《中华医院感染学杂志》2024年第4期527-530,共4页Chinese Journal of Nosocomiology

基　　金：河北省卫生厅医学科学研究基金资助项目(ZD20140393)。

摘　　要：目的探究头颈部肿瘤患者放疗合并肺部感染的危险因素及D-二聚体(D-D)、降钙素原(PCT)、C-反应蛋白(CRP)对其预测价值.方法选择2018年1月—2022年12月河北医科大学第四医院收治的头颈部肿瘤患者610例作为研究对象,根据放疗期间肺部感染情况分为研究组(合并肺部感染,31例)和对照组(未合并肺部感染,579例),检测两组患者血清D-D、PCT、CRP水平并分析预测价值,归纳头颈部肿瘤患者放疗合并肺部感染危险因素;采用受试者工作特征(ROC)曲线分析各指标对头颈部肿瘤放疗期间肺部感染的预测价值.结果研究组CRP、PCT及D-D水平均高于对照组(P<0.05);多因素Logistic回归分析结果显示,年龄、侵入性操作、合并化疗是头颈部肿瘤患者放疗期间肺部感染的危险因素;血清CRP、PCT及D-D均对患者肺部感染具有较高的预测价值,三者联合检测预测价值最高.结论头颈部肿瘤患者年龄、侵入性操作、合并化疗是放疗合并肺部感染的危险因素;血清CRP、PCT以及D-D水平能有效预测头颈部肿瘤患者肺部感染情况.OBJECTIVE To explore the risk factors for pulmonary infection during radiotherapy for head and neck tumors and the predictive value of serum levels of D-dimer(D-D),procalcitonin(PCT),C-reactive protein(CRP).METHODS Totally 610 patients with head and neck tumors admitted to the Fourth Hospital of Hebei Medical Uni-versity from Jan.2018 to Dec.2022 were selected as the study subjects.and they were divided into a study group(combined with pulmonary infection,31 cases)and a control group(not combined with pulmonary infection,579 cases)according to pulmonary infection during the radiotherapy period.The serum levels of D-D,PCT,and CRP of the two groups were measured and the predictive value were analyzed,and the risk factors for pulmonary infec-tion combined with radiotherapy in patients with head and neck tumors;the predictive value of each index of pul-monary infection during radiotherapy for head and neck tumors were analyzed by the reveiver operating character-istics(ROC)curves.RESULTS The average levels of serum CRP,PCT,and D-D water in the study group were significantly higher than those in the control group;The results of multivariate logistic regression analysis indica-ted that age,invasive procedures and combined chemotherapy were independent risk factors affecting the occur-rence of lung infection in patients with head and neck tumors during radiotherapy.Serum CRP,PCT and D-D all had high predictive value for pulmonary infection,and the combination of all three tests had the highest predictive value.CONCLUSION Age,invasive procedures,and concurrent chemotherapy in patients with head and neck tumors were risk factors for concurrent lung infection in the patients undergoing radiotherapy;serum CRP,PCT,and D-D levels could effectively predict pulmonary infection in patients with head and neck tumors.

关 键 词：头颈部肿瘤 放疗 肺部感染 病原菌 危险因素 D-二聚体 降钙素原 C-反应蛋白 

分 类 号：R563.1[医药卫生—呼吸系统]