胃肠肿瘤患者血糖水平及炎症反应的相关性研究  

Study on the correlation between blood sugar levels and inflammatory response in patients with gastrointestinal tumors

作　　者：张红艳 丁宣尹 雷迁 ZHANG Hong-yan;DING Xuan-yin;LEI Qian(School of Clinical Medicine,Southwest Medical University,Luzhou 646000,China;Department of Anesthesiology,Chengdu Wenjiang District People's Hospital,Chengdu 610000,China;Sichuan Academy of Medical Sciences&Sichuan Provincal People's Hospital(Affiliated Hospital of University of Electronic Science and Technology of China),Chengdu 610072,China;Department of Anesthesiology,Zigong Fourth People's Hospital,Zigong 643000,China)

机构地区：[1]西南医科大学临床医学院,四川泸州646000 [2]成都市温江区人民医院麻醉科,四川成都610000 [3]四川省医学科学院·四川省人民医院(电子科技大学附属医院),四川成都610072 [4]四川省自贡市第四人民医院麻醉科,四川自贡643000

出　　处：《实用医院临床杂志》2025年第2期109-113,共5页Practical Journal of Clinical Medicine

基　　金：四川省科技厅重点研究项目(编号:2023YFS0036)。

摘　　要：目的探讨高血糖对胃肠肿瘤患者术后炎症反应的影响,分析患者术后发生感染的危险因素。方法回顾性分析2021年1月至2023年12月行胃肠肿瘤手术的患者100例,根据患者术前血糖水平分为高血糖组(53例)和正常血糖组(47例)。比较两组患者一般临床资料、术前术后C反应蛋白(CRP)水平、免疫细胞水平及术后感染情况,采用多因素Logistic回归模型分析术后感染的危险因素。结果两组患者体重指数、术后CRP水平,术后单核细胞/淋巴细胞比值(MRL)、术后感染率方面差异均有统计学意义(P均<0.05);高血糖组患者术后CRP水平较正常血糖组明显升高(P<0.001);高血糖组患者术后MRL值显著高于正常血糖组(P<0.001)。是否发生术后感染、两组间总住院天数、术后住院天数、术前单核细胞值、术后MRL值与是否发生吻合口瘘比较,差异有统计学意义(P均<0.05),多因素logistic回归分析显示,术后MRL是患者发生术后感染的独立危险因素(P<0.05)。结论术前高血糖胃肠肿瘤患者术后CRP水平、MRL值明显增高,高血糖组患者术后感染发生率高于正常血糖组,术后MRL是患者发生术后感染的独立危险因素。Objective To explore the effect of hyperglycaemia on postoperative inflammatory response in patients with gastrointestinal tumours,and to investigate the risk factors of postoperative infection in these patients.Methods One hundred patients who underwent gastrointestinal tumour surgery from January 2021 to December 2023 were retrospectively analyzed.The patients were divided into a hyperglycaemia group(n=53)and a normoglycaemia group(n=47)according to their preoperative blood glucose levels.General clinical data,CRP levels before and after,immune cell levels and postoperative infections were compared between the two groups.Mmultivariate logistic regression model was used to analyze the risk factors of postoperative infection.Results There were significant differences in body mass index(BMI),postoperative CRP level,monocyte lymphocyte ratio(MLR)value,and postoperative infection rate between the two groups(all P<0.05).The postoperative CRP level of the hyperglycaemic group was significantly higher than that of the normoglycaemic group(P<0.001).The postoperative MLR value of the hyperglycemia group was significantly higher than that of the normoglycemia group(P<0.001).There were significant differences in total hospitalization days,postoperative hospitalization days,mononuclear cell values before operation,MLR values after operation and occurrence of anastomotic leakage between the two groups(all P<0.05).Mmultivariate logistic regression analysis showed that postoperative MLR was an independent risk factor for postoperative infection in the patients(P<0.05).Conclusions Postoperative CRP level and MLR value are significantly higher in patients with gastrointestinal tumors and preoperative hyperglycaemia.The incidence of postoperative infections is higher in the hyperglycaemic group than that in the normoglycaemic group.Postoperative MLR is an independent risk factor for postoperative infections in the patients.

关 键 词：血糖 胃肠肿瘤 炎症反应 免疫细胞 

分 类 号：R619[医药卫生—外科学]