胃癌根治术围术期血清IL-6、HBP、T淋巴亚群水平变化及预测院内感染的价值分析  

Value of changes in perioperative serum interleukin-6,heparin-binding protein,and T-lymphocyte subpopulations in predicting nosocomial infections in radical gastric cancer surgery

作　　者：毛莉莉 孙艳 姜文兰 Li-Li Mao;Yan Sun;Wen-Lan Jiang(Zhejiang Xinan International Hospital,Jiaxing 314001,Zhejiang Province,China)

机构地区：[1]浙江新安国际医院检验科,浙江省嘉兴市314001 [2]浙江新安国际医院院感科,浙江省嘉兴市314001 [3]浙江新安国际医院老年科,浙江省嘉兴市314001

出　　处：《世界华人消化杂志》2024年第4期285-292,共8页World Chinese Journal of Digestology

摘　　要：背景胃癌根治术是治疗胃癌患者的主要手术,但是存在术后感染的风险,感染一旦发生,发展迅速,严重影响患者术后的身体恢复,甚至危及生命.对感染的早发现是治疗的关键.目的分析胃癌根治术围术期血清白细胞介素(interleukin,IL)-6、肝素结合蛋白(heparin-binding protein,HBP)、T淋巴亚群水平变化及预测院内感染的价值,为临床胃癌诊疗提供有利参考.方法选取2020-01/2023-10于我院行胃癌根治术治疗,术后发生院内感染的57例胃癌患者作为感染组,另选同期未发生院内感染的63例患者作为未感染组.比较两组血清IL-6、HBP、T淋巴亚群,包括分化簇3^(+)(cluster of differentation 3^(+),CD3^(+))、分化簇4^(+)(cluster of differentation 4^(+),CD4^(+))、CD4^(+)/CD8^(+)水平,并分析手术前后各指标变化值与院内感染病情程度的相关性、预测胃癌根治术后发生院内感染的价值.结果感染组术后外周血白细胞(white blood cell,WBC)、血清降钙素原(procalcitonin,PCT)、IL-6、HBP水平高于未感染组,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平低于未感染组,且感染组△WBC、△PCT、△IL-6、△HBP、△CD3^(+)、△CD4^(+)、△CD4^(+)/CD8^(+)均大于未感染组(均为P<0.05);重度感染患者△IL-6、△HBP、△CD3^(+)、△CD4^(+)、△CD4^(+)/CD8^(+)均大于轻度感染患者(P<0.05);感染组△IL-6、△HBP、△CD3^(+)、△CD4^(+)、△CD4^(+)/CD8^(+)均与院内感染病情程度呈正相关(P<0.05);△WBC、△PCT、△IL-6、△HBP、△CD3^(+)、△CD4^(+)、△CD4^(+)/CD8^(+)预测胃癌患者胃癌根治术后发生院内感染的受试者工作特征曲线和曲线下面积分别为0.792、0.769、0.810、0.762、0.748、0.772、0.820,△IL-6、△HBP、△CD3^(+)、△CD4^(+)、△CD4^(+)/CD8^(+)预测院内感染的AUC与△WBC、△PCT比较,差异无统计学意义;与各指标单独预测比较,联合预测的AUC明显增大,NRI、IDI均>0(P<0.05).结论胃癌根治术围术期血清IL-6、HBP、T淋巴BACKGROUND Radical gastrectomy is the main operation for the treatment of gastric cancer patients,but there is a risk of postoperative infection.Once the infection occurs,it develops rapidly,seriously affecting the postoperative recovery of patients and even endangering their lives.Thus,early detection of such infection is key to the treatment of gastric cancer.AIM To analyze the changes of serum interleukin-6(IL-6),heparin-binding protein(HBP)and T-lymphoid subsets during the perioperative period of radical gastrectomy and to assess their value in predicting nosocomial infections.METHODS Fifty-seven gastric cancer patients who underwent radical gastric cancer treatment at our hospital from January 2021 to October 2023 and developed nosocomial infections after surgery were selected as an infection group,and 63 patients who did not develop nosocomial infections in the same period were selected as an uninfected group.The levels of serum IL-6,HBP,and T-lymphocyte subgroups(CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)ratio)before and after the operation were compared between the two groups.The correlation between the changes of the above indexes and the severity of nosocomial infection was analyzed,and their value in predicting the occurrence of nosocomial infections after radical surgery for gastric cancer was assessed.RESULTS Postoperative peripheral blood white blood cell count(WBC)and serum PCT,IL-6,and HBP levels were higher in the infected group than in the uninfected group,CD3^(+)and CD4^(+)T-lymphocytes and CD4^(+)/CD8^(+)ratio were lower than those in the uninfected group,and△WBC,△PCT,△IL-6,△HBP,△CD3^(+),△CD4^(+),and△CD4^(+)/CD8^(+)ratio in the infected group were greater than those in the uninfected group(P<0.05 for all).In the infection group,their were 32 cases of mild infection and 25 cases of severe infection.In patients with severe infection,△IL-6,△HBP,△CD3^(+),△CD4^(+),and△CD4^(+)/CD8^(+)ratio were higher than those of patients with mild infection(P<0.05).In the infection group,△IL-6,

关 键 词：胃癌根治术 肝素结合蛋白 白细胞介素6 院内感染 T淋巴亚群 

分 类 号：R735.2[医药卫生—肿瘤]