食管癌术后重症肺炎患者血清肺表面活性物质相关蛋白质-D、高迁移率族蛋白B1和中性粒细胞与淋巴细胞比值水平变化及检测意义  

Changes and detection significance of serum pulmonary surfactant associated protein,high mobility group box 1 protein and neutrophil-to-lymphocyte ratio in patients with severe pneumonia after esophageal cancer surgery

作　　者：张少锋 李丹青 杜凡 魏志强[1] 王海军[1] ZHANG Shaofeng;LI Danqing;DU Fan;WEI Zhiqiang;WANG Haijun(Department of Thoracic Surgery,Xingtai People’s Hospital,Xingtai 054001,China)

机构地区：[1]邢台市人民医院胸外科,河北邢台054001

出　　处：《陕西医学杂志》2024年第8期1114-1117,1123,共5页Shaanxi Medical Journal

基　　金：河北省自然科学基金资助项目(H2022206546)。

摘　　要：目的:探讨中性粒细胞与淋巴细胞比值(NLR)、肺表面活性物质相关蛋白质-D(SP-D)及高迁移率族蛋白B1(HMGB1)在食管癌术后重症肺炎(SP)患者中的水平变化及检测意义。方法:选取接受手术治疗的食管癌患者257例,根据手术治疗后是否发生SP将患者分为SP组(124例)和对照组(133例)。比较两组血清SP-D、HMGB1和NLR水平。记录SP组患者28 d内预后情况,根据28 d内生存情况将SP组患者分为生存组(104例)和病死组(20例)。比较两组一般资料及实验室指标,采用Logistic回归分析食管癌术后SP患者预后影响因素。绘制受试者工作特征(ROC)曲线分析NLR、SP-D及HMGB1对食管癌术后SP患者28 d内病死风险的预测价值。结果:SP组血清SP-D及HMGB1和NLR水平高于对照组(均P<0.05)。病死组NLR、SP-D及HMGB1水平高于生存组(均P<0.05)。NLR、SP-D及HMGB1是食管癌术后SP患者病死的影响因素(均P<0.05)。NLR、SP-D及HMGB1预测食管癌术后SP患者28 d内病死风险的AUC分别为0.744、0.763、0.715,而三者联合检测的AUC更高(均P<0.05)。结论:食管癌术后SP患者NLR、SP-D及HMGB1水平升高,且与患者预后有关,三者联合检测有助于提升对患者病死风险的预测价值。Objective:To investigate the changes and detection significance of neutrophil-to-lymphocyte ratio(NLR),pulmonary surfactant associated protein(SP-D)and high mobility group box 1 protein(HMGB1)in patients with severe pneumonia(SP)after esophageal cancer surgery.Methods:A total of 257 patients with esophageal cancer who underwent surgical treatment were selected.According to whether SP occurred after surgical treatment,the patients were divided into SP group(124 cases)and control group(133 cases).The levels of serum SP-D,HMGB1 and NLR were compared between the two groups.The prognosis of patients in SP group within 28 days was recorded.Patients in SP group were divided into survival group(104 cases)and death group(20 cases)according to 28-day survival.The general data and laboratory indexes of the two groups were compared.Logistic regression was used to analyze the prognostic factors of SP patients after esophageal cancer surgery.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of NLR,SP-D and HMGB1 for the risk of death within 28 days of SP patients after esophageal cancer surgery.Results:The levels of serum SP-D,HMGB1 and NLR in the SP group were higher than those in the control group(all P<0.05).The levels of NLR,SP-D and HMGB1 in the death group were higher than those in the survival group(all P<0.05).NLR,SP-D and HMGB1 were the influencing factors for the death of SP patients after esophageal cancer surgery(all P<0.05).The AUC of NLR,SP-D and HMGB1 in predicting the mortality risk of SP patients after esophageal cancer surgery within 28 days was 0.744,0.763 and 0.715,respectively,and the AUC of the combined detection of the three was higher(all P<0.05).Conclusion:The levels of NLR,SP-D and HMGB1 in SP patients after esophageal cancer surgery are increased,and they are related to the prognosis of patients.The combined detection of the three can help to improve the predictive value for the death risk of patients.

关 键 词：食管癌 重症肺炎 中性粒细胞与淋巴细胞比值 肺表面活性物质相关蛋白质-D 高迁移率族蛋白B1 预后 

分 类 号：R735.1[医药卫生—肿瘤]