IL-6、PCT、CRP及WBC与老年腹部手术患者术后肺部感染的相关性  

Correlation of IL-6,PCT,CRP,and WBC with Postoperative Pulmonary Infection in Elderly Patients Undergoing Abdominal Surgery

作　　者：李红宇 董娜 LI Hongyu;DONG Na(Department of Laboratory Medicine,Puyang Traditional Chinese Medicine Hospital,Puyang Henan 457000,China)

机构地区：[1]濮阳市中医医院检验科,河南濮阳457000

出　　处：《临床研究》2025年第1期113-117,共5页Clinical Research

摘　　要：目的研究血白细胞介素-6(IL-6)、降钙素原(PCT)、C反应蛋白(CRP)及白细胞计数(WBC)与老年腹部手术后早期肺部感染的相关性。方法收集2023年1月至2023年12月濮阳市中医医院收治的45例老年腹部手术后早期肺部感染患者作为感染组,另按1∶2比例抽取同期行腹部手术但术后早期未出现肺部感染的90例作为未感染组,所有病例术后次日清晨均采集血样完成IL-6、PCT、CRP、WBC检测,比较感染组与未感染组上述指标差异,分析早期肺部感染患者病原菌分布,比较不同感染严重程度患者上述指标的差异,分析以上各指标与肺部感染严重程度的关系,并应用受试者工作曲线(ROC)分析以上参数诊断老年腹部手术后早期肺部感染的效能。结果腹部手术后早期肺部感染病原菌分布主要以革兰阴性菌(77.78%)为主,其中铜绿假单胞菌所占比例最高(53.33%,其次为大肠埃希菌(15.56%);革兰阳性菌(17.78%)中金黄色葡萄球菌所占比例最高(11.11%);真菌占4.44%,均为白假丝酵母菌;感染组术后次日清晨血IL-6、PCT、CRP、WBC水平均高于未感染组,差异均有统计学意义(P<0.05);不同严重程度肺部感染患者术后次日各实验室指标比较差异有统计学意义,随感染严重程度的上升,IL-6、PCT、CRP、WBC水平上升,差异均有统计学意义(P<0.05);IL-6、PCT、CRP、WBC均与临床肺部感染评分(CPIS)呈正相关,差异均有统计学意义(r=0.716、0.765、0.725、0.735,P<0.05);IL-6、PCT、CRP、WBC联合检测诊断腹部手术早期肺部感染的曲线下面积(AUC)值高于单项检测,差异均有统计学意义(P<0.05)。结论IL-6、PCT、WBC及CRP对老年腹部外科术后早期肺部感染皆有一定的诊断价值,且联合检测诊断效能更高,可将其作为腹部外科术后早期肺部感染筛查的重要指标。Objective To investigate the correlation of serum interleukin-6(IL-6),procalcitonin(PCT),C-reactive protein(CRP),and white blood cell count(WBC)with early pulmonary infection after abdominal surgery in elderly patients.Methods A total of 45 elderly patients with early pulmonary infection after abdominal surgery treated at Puyang Traditional Chinese Medicine Hospital from January 2023 to December 2023 were selected as the infection group.In addition,90 patients who underwent abdominal surgery but did not develop postoperative pulmonary infections were selected as the non-infection group at a ratio of 1:2.Blood samples were collected for the measurement of IL-6,PCT,CRP,and WBC levels on the morning following surgery.The differences in these indicators between the infection and non-infection groups were compared.The distribution of pathogens in early pulmonary infection patients was analyzed,and differences in these indicators across various severities of infection were compared.The relationships between the mentioned indicators and the severity of pulmonary infection were analyzed,and receiver operating characteristic(ROC)curves were utilized to assess the diagnostic efficacy of these parameters for early pulmonary infection after abdominal surgery.Results The distribution of pathogens in early postoperative pulmonary infections was predominantly gram-negative bacteria(77.78%),with Pseudomonas aeruginosa being the most common(53.33%),followed by Escherichia coli(15.56%).Among gram-positive bacteria(17.78%),Staphylococcus aureus predominated(11.11%),and fungi accounted for 4.44%,all of which were Candida albicans.On the morning after surgery,the levels of IL-6,PCT,CRP,and WBC in the infection group were significantly higher than those in the non-infection group(P<0.05).There were statistically significant differences in laboratory indicators when comparing patients with varying severities of pulmonary infection,with IL-6,PCT,CRP,and WBC levels rising as infection severity increased(P<0.05).Moreover,IL-6,PCT,CRP,and

关 键 词：腹部手术 肺部感染 白细胞介素-6 C反应蛋白 白细胞计数 

分 类 号：R56[医药卫生—呼吸系统]