摘要
目的探索肺癌患者围手术期感染的血清炎症因子与N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)的改变情况。方法选取2014年6月-2018年6月于承德医学院附属医院接受治疗的94例肺癌患者为研究对象,按照患者围手术期是否发生感染分为感染组和未感染组。分析感染患者病原菌检出情况。采集患者外周血检测血清炎症因子降钙素原(procalcitonin,PCT)、白介素-6(Interleukin-6,IL-6)、C-反应蛋白(C-reactive protein,CRP)和NT-proBNP指标水平。结果 94例肺癌患者术后发生感染患者28例,感染率为29.79%;其中16例肺部感染占57.14%,8例创口感染28.57%,4例其他感染占比14.29%。28例肺癌术后感染患者共检出39株病原菌,其中革兰阴性菌26株,革兰阳性菌10株,真菌3株。手术前感染组和未感染组患者PCT、IL-6、CRP、NT-proBNP水平比较差异无统计学意义,手术后感染组患者PCT、IL-6、CRP、NT-proBNP指标水平分别为(0.48±0.09)ng/ml、(89.62±20.34)pg/ml、(112.35±25.64)mg/L、(139.82±26.89)pg/ml均明显高于未感染组(P<0.05)。结论肺部感染是肺癌患者术后的主要感染类型,感染病原菌主要为革兰阴性菌,临床医师在治疗时可以根据患者病原菌种类合理使用抗菌药物,且患者感染后血清炎症因子及NT-proBNP水平变化明显,可以作为肺癌患者术后感染的辅助检查指标。
OBJECTIVE To explore the changes of serum inflammatory factors and N-terminal pro-brain natriuretic peptide(NT-proBNP) of the lung cancer patients with perioperative infection. METHODS A total of 94 lung cancer patients who were treated in the Affiliated Hospital of Chengde Medical College from Jun 2014 to Jun 2018 were recruited as the study objects and divided into the infection group and the non-infection group according to the status of perioperative infection.The distribution of the isolated pathogens was observed.The peripheral blood specimens were collected to determine the levels of serum inflammatory factors procalcitonin(PCT), interleukin-6(IL-6), C-reactive protein(CRP) and NT-proBNP. RESULTS Of the 94 patients with lung cancer, 28 had postoperative infection, with the infection rate 29.79%, 16(57.14%) of whom had pulmonary infection, 8(28.57%) had wound infection, and 4(14.29%) had other infections.Totally 39 strains of pathogens were isolated from the 28 lung cancer patients with postoperative infection, 26 of which were gram-negative bacteria, 10 were gram-positive bacteria, and 3 were fungi.There were no significant differences in the levels of PCT, IL-6, CRP and NT-proBNP between the infection group and the non-infection group before the surgery.The levels of PCT, IL-6, CRP and NT-proBNP of the infection group were respectively(0.48±0.09)ng/ml,(89.62±20.34)pg/ml,(112.35±25.64)mg/L and(139.82±26.89)pg/ml after the surgery, significantly higher than those of the non-infection group(P<0.05). CONCLUSION The lung cancer patients with pulmonary infection are dominant among the patients with postoperative infection, the gram-negative bacteria are the predominant pathogens causing the infection.It is necessary for the clinicians to reasonably use antibiotics based on the species of pathogens.The levels of serum inflammatory factors and NT-proBNP change remarkably after the patients were infected, which can be used as the auxiliary examination indexes for the lung cancer patients with postoperative infection.
作者
王丽萍
孙常铭
张日
姜子斌
华正祥
WANG Li-ping;SUN Chang-ming;ZHANG Ri;JIANG Zi-bin;HUA Zheng-xiang(Affiliated Hospital of Chengde Medical College,Chengde,Hebei 067000,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第2期220-223,共4页
Chinese Journal of Nosocomiology
基金
承德市科技计划资助项目(2018672)。
关键词
肺癌
围手术期感染
血清炎症因子
N末端脑钠肽前体
Lung cancer
Perioperative infection
Serum inflammatory factor
N-terminal pro-brain natriuretic peptide
