摘要
目的:探讨肺癌化疗住院患者院内感染危险因素及炎症因子、T淋巴细胞亚群改变。方法:采用回顾性研究的方法,选择我院呼吸内科2015年1~2019年10月收治的肺癌化疗住院患者106例作为研究对象,根据其在院内化疗期间是否发生感染分为感染组(n=30)和非感染组(n=76)。对感染组患者病原分布及两组患者炎性因子C反应蛋白(CRP)、降钙素原(PCT)和白介素6(IL-6)水平及外周血CD4+T淋巴细胞、CD8+T淋巴细胞、CD4/CD8比值水平进行比较,探讨其发生的危险因素。结果:30例患者共检出病原35例,其中革兰氏阳性菌25例,占71.43%,革兰氏阳性菌9例,占25.71%;感染组CD4+T淋巴细胞、CD4/CD8水平显著低于非感染组患者,CD8+T淋巴细胞水平显著高于非感染组患者;感染组CRP、PCT、IL-6水平显著高于非感染组患者;单因素分析及多元Logistic分析结果表明,肿瘤分期III^IV期、入院时CD4/CD8、CRP、PCT、IL-6水平是肺癌化疗住院患者医院感染的独立危险因素。结论:除患者临床特征外,入院时炎性因子及T淋巴细胞水平也是肺癌化疗住院患者发生医院感染的危险因素,应加强对高危人群的病原培养及重点监控,尽早采取防控措施。
Objective To investigate the risk factors of nosocomial infection and the changes of inflammatory factors and T lymphocyte subsets in patients with lung cancer chemotherapy.Methods 106 patients with lung cancer chemotherapy admitted to our department of respiratory medicine from January 2015 to October 2019 were selected as the research subjects.They were divided into infection groups according to whether they had infection during the in-hospital chemotherapy(n=30)and non-infected group(n=76).Distribution of pathogens in patients in the infection group and levels of inflammatory factor C-reactive protein(CRP),procalcitonin(PCT)and interleukin 6(IL-6),and peripheral blood CD4+T lymphocytes and CD8+T lymphocytes in the two groups The ratio of CD4/CD8 ratio was compared to explore the risk factors.Results A total of 35 pathogens were detected in 30 patients,of which 25 were Gram-positive bacteria,accounting for 71.43%,and 9 were Gram-positive bacteria,accounting for 25.71%.The levels of CD4+T lymphocytes and CD4/CD8 were significantly lower in the infection group.In the non-infected group,the levels of CD8+T lymphocytes were significantly higher than in the non-infected group;the levels of CRP,PCT,and IL-6 in the infected group were significantly higher than in the non-infected group;univariate analysis The results of multivariate logistic analysis showed that tumor stages III to IV,CD4/CD8,CRP,PCT,and IL-6 levels at admission were independent risk factors for nosocomial infection in patients receiving lung cancer chemotherapy.Conclusion In addition to the clinical characteristics of patients,the levels of inflammatory factors and T lymphocytes at the time of admission are also risk factors for nosocomial infections in hospitalized patients with chemotherapy for lung cancer.The pathogenic cultivation and key monitoring of high-risk groups should be strengthened,and preventive measures should be taken as soon as possible.
作者
仰杰
颜刚林
高建荣
Yang Jie;Yan Gang-lin;Gao Jian-rong(Department of Respiratory Medicine,Chaohu Hospital,Anhui Medical University,Hefei 238000,China)
出处
《湖南师范大学学报（医学版）》
2020年第4期100-103,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
肺癌
院内感染
炎性因子
T淋巴细胞
lung cancer
nosocomial infection
inflammatory factor
T lymphocyte
