摘要
目的分析多发性骨髓瘤(MM)化疗后合并肺部感染患者呼吸及炎症指标水平变化情况。方法收集2017年10月至2019年10月于该院行化疗的80例MM患者的临床资料,其中40例化疗后发生肺部感染患者为感染组,根据感染严重程度分为轻度感染10例,中度感染21例,重度感染9例;40例化疗后未发生感染患者为未感染组。比较两组患者和感染组不同严重程度患者呼吸及炎症指标水平的差异,其中呼吸功能指标包括气道阻力(RAW)、响应频率(Fres)、气道平均压(Pmean)及动态胸肺顺应性(Cdyn);炎症指标包括降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)。采用Spearman相关性分析病情严重程度与呼吸及炎症指标水平的相关性;并采用受试者工作特征曲线(ROC)评价呼吸及炎症指标对MM患者化疗后合并肺部感染的诊断价值。结果感染组患者RAW、Fres及Pmean水平显著高于未感染组(P<0.05);Cdyn水平明显低于未感染组(P<0.05);感染组RAW、Fres及Pmean水平随感染程度的加重而升高(P<0.05),Cdyn水平随感染程度的加重而降低(P<0.05)。感染组PCT、hs-CRP、TNF-α、IL-6水平显著高于未感染组(P<0.05),且随感染程度的加重而升高(P<0.05)。经Spearman相关性分析显示,MM化疗后合并肺部感染患者呼吸指标(RAW、Fres、Pmean)及炎症指标水平与感染严重程度呈正相关(P<0.05),Cdyn水平与感染严重程度呈负相关(P<0.05)。ROC曲线显示,呼吸及炎症指标对MM化疗后合并肺部感染均具有较好的诊断价值。结论MM化疗后并发肺部感染患者呼吸指标功能差,炎症因子异常高表达,提示呼吸及炎症指标可作为MM化疗后合并肺部感染的诊断及评估病情严重程度的重要指标。
Objective To investigate the changes of respiratory and inflammatory indexes in the patients of multiple myeloma(MM)complicating pulmonary infection after chemotherapy.Methods The clinical data of 80 patients with MM undergoing chemotherapy admitted to this hospital from October 2017 to October 2019 were collected.Among them,40 cases of lung infection after chemotherapy served as the infection group:10 cases of mild infection,21 cases of moderate infection and 9 cases of severe infection;and 40 cases of non-infection after chemotherapy served as the non-infection group.The differences in the levels of respiratory and inflammatory indexes were compared between the two groups and among the patients with different severity degrees in the infection group.The respiratory function indexes included the airway resistance(RAW),response frequency(Fres),mean airway pressure(Pmean)and dynamic thoracic and pulmonary compliance(Cdyn),and the inflammatory indexes included PCT,hs-CRP,IL-6 and TNF-α.The Spearman correlation analysis was adopted to analyze the correlation between the disease severity and the levels of respiratory and inflammatory indexes,and the receiver operating characteristic(ROC)curve was adopted to evaluate the diagnostic value of the respiratory and inflammatory indexes to complicating pulmonary infection after chemotherapy in the patients with MM.Results The levels of RAW,Fres and Pmean in the infection group were significantly higher than those in the non-infection group(P<0.05)and the Cdyn level was significantly lower than that in the non-infection group(P<0.05).The levels of RAW,Fres and Paean in the infection group were increased with the infection severity increase,while the Cdyn level was decreased with the infection severity increase(P<0.05).The levels of PCT,hs-CRP,IL-6 and TNF-αin the infection group were significantly higher than those in the non-infection group(P<0.05),moreover which were increased with the infection severity increase(P<0.05).The Spearman correlation analysis showed that the levels of respiratory indexes(RAW,Fres,Pmean)and inflammatory indexes after chemotherapy in the patients with MM complicating pulmonary infection were positively correlated with the severity degree of infection(P<0.05)and the Cdyn level was negatively correlated with the severity degree of infection(P<0.05).The ROC curve revealed that the respiratory and inflammatory indexes had better diagnostic value for MM complicating pulmonary infection after chemotherapy.Conclusion The function of respiratory indexes is poor and the inflammatory factors are abnormally highly expressed after chemotherapy in the patients with MM complicating lung infection,which suggesting that the respiratory and inflammatory indexes can serve as the important indexes for diagnosing the pulmonary infection and evaluating the severity.
作者
褚娜利
张靖宇
郭丽
张华
范洪
CHU Nali;ZHANG Jingyu;GUO Li;ZHANG Hua;FAN Hong(Department of Laboratory Diagnosis,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,Hebei 061001,China;Department of Hematology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,Hebei 061001,China)
出处
《重庆医学》
CAS
2021年第8期1309-1313,共5页
Chongqing medicine
基金
河北省人才工程培养资助项目(A201901110)
河北省卫生健康委员会重点科技研究计划项目(20191283)
沧州市科学技术研究与发展指导计划项目(172302167)。
关键词
多发性骨髓瘤
化疗
肺部感染
呼吸指标
炎症指标
multiple myeloma
chemotherapy
pulmonary infection
respiratory index
inflammatory index
