| 马 勇,杨建栋,罗 涌,谢正勇,罗逸潜.血清PCT、CRP以及T淋巴细胞亚群的动态变化及与胃癌患者术后感染性并发症的关系[J].,2019,19(20):3857-3861 |
| 血清PCT、CRP以及T淋巴细胞亚群的动态变化及与胃癌患者术后感染性并发症的关系 |
| Relationship between Dynamic Changes of Serum PCT, CRP and T Lymphocyte Subsets and Postoperative Infectious Complications in Patients with Gastric Cancer |
| 投稿时间：2019-05-03 修订日期：2019-05-28 |
| DOI：10.13241/j.cnki.pmb.2019.20.013 |
| 中文关键词: 胃癌 感染性并发症 降钙素原 C反应蛋白 T淋巴细胞亚群 预测价值 |
| 英文关键词: Gastric cancer Infectious complications Procalcitonin C reactive protein T lymphocyte subsets Predictive value |
| 基金项目:辽宁省科学技术计划项目（2015010412-301） |
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| 中文摘要: |
| 摘要 目的：探讨血清降钙素原（PCT）和C反应蛋白（CRP）以及T淋巴细胞亚群的动态变化及与胃癌患者术后感染性并发症的关系。方法：选取2014年1月到2017年10月期间在中国人民解放军联勤保障部队第967医院接受治疗的胃癌患者163例，根据患者术后是否出现感染性并发症将其分为感染组和未感染组，其中感染组83例，未感染组80例，计算感染组患者各种术后感染性并发症的构成比例，检测术前、术后1d、术后3d血清PCT、CRP以及T淋巴细胞亚群的动态变化。采用ROC曲线分析PCT、CRP对感染性并发症的预测价值。结果：胃癌患者术后感染性并发症种类主要为肺部感染和手术部位感染，其次为腹腔感染和十二指肠残端瘘。术后1d、术后3d两组患者血清中PCT、CRP的水平明显高于术前（P<0.05），术后1d、术后3d感染组患者血清中PCT的水平高于未感染组（P<0.05），术后3d感染组血清中CRP的水平较未感染组升高（P<0.05）；经ROC曲线分析显示，术后3d血清PCT对胃癌患者术后感染性并发症的曲线下面积（AUC）为0.90，高于CRP的0.81；术后1d、术后3d两组患者的CD3+、CD4+、CD4+/CD8+均明显低于术前，术后1d、术后3d感染组患者的CD8+明显高于术前（P<0.05）；术后3d感染组患者的CD3+、CD4+、CD4+/CD8+均明显低于未感染组（P<0.05）。结论：血清PCT、CRP以及T淋巴细胞亚群的动态变化与胃癌患者术后感染性并发症密切相关，且PCT对胃癌患者术后感染性并发症的预测价值高于CRP。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between the dynamic changes of serum procalcitonin (PCT), C reactive protein (CRP) and T lymphocyte subsets and postoperative infectious complications in patients with gastric cancer. Methods: 163 cases of patients with gastric cancer who were treated in the 967th Hospital of the PLA Joint Logistics Support Force from January 2014 to October 2017 were selected. The patients were divided into infected group and uninfected group according to whether there were infectious complications after operation. Among them there were 83 cases in the infected group and 80 cases in the uninfected group. The proportion of postoperative infectious complications in the infected group were calculated, the dynamic changes of serum PCT, CRP and T lymphocyte subsets were detected before operation, 1d after operation and 3d after operation. The predictive value of PCT and CRP for infectious complications by ROC curve analysis. Results: The main postoperative infectious complications of patients with gastric cancer were pulmonary infection and surgical site infection, the secondly were abdominal infection and duodenal stump fistula. The levels of serum PCT and CRP in the patients of two groups at 1d after operation and 3d after operation were significantly higher than those before operation (P<0.05). The level of serum PCT in the infected group at 1d after operation and 3d after operation were higher than that in the uninfected group (P<0.05). The level of serum CRP in the infected group at 3d after operation was higher than that in the uninfected group (P<0.05). After ROC curve analysis, the curve area (AUC) of 3d after operation serum PCT for postoperative infectious complications of patients with gastric cancer was 0.90, which was higher than CRP 0.81. The CD3+, CD4+, CD4+/CD8+ in the patients of two groups at 1d after operation and 3d after operation were significantly lower than those before operation, the CD8+ in the infected group at 1d after operation and 3d after operation were significantly higher than those before operation (P<0.05). The CD3+, CD4+ and CD4+/CD8+ in the infected group at 3d after operation were significantly lower than those in the uninfected group (P<0.05). Conclusion: The dynamic changes of serum PCT, CRP and T lymphocyte subsets are closely related to the postoperative infectious complications of patients with gastric cancer, and the predictive value of PCT for postoperative infectious complications of patients with gastric cancer is higher than that of CRP. |
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