摘要
目的 探讨CD4^(+)/CD8^(+)联合改良临床肺部感染(mCPIS)评分、营养风险筛查(NRS2002)评分预测食管癌胸腔镜术后肺部感染价值。方法 选取2020年12月至2021年10月衡水市第三人民医院与衡水市第二人民医院收治的120例行食管癌胸腔镜术病人进行前瞻性队列研究,根据术后住院期间是否发生肺部感染分为感染组、未感染组,采用logistic回归构建食管癌胸腔镜术后肺部感染状态的联合预测因子模型,并绘制受试者操作特征(ROC)曲线。结果 感染组CD4^(+)/CD8^(+)(0.78±0.14)低于未感染组(1.06±0.18)(P<0.05);感染组mCPIS评分、NRS2002评分分别为(3.49±1.13)分、(10.89±2.18)分高于未感染组的(1.02±0.28)分、(6.22±2.49)分(P<0.05);CD4^(+)/CD8^(+)、mCPIS、NRS2002评分均是影响感染发生的相关影响因素(P<0.05),生成联合预测因子模型表达式:logit(P)=-5.007-0.702×X_(1)+1.832×X_(2)+1.934×X_(3);ROC分析显示联合预测因子预测效能最高,联合预测因子最佳截断值为0.11,预测准确率为83.33%。结论 CD4^(+)/CD8^(+)、mCPIS、NRS2002评分均与食管癌胸腔镜术后肺部感染发生有关,基于三者生成的联合预测因子有望为临床预测术后肺部感染风险提供准确的参考信息。
Objective To explore the value of CD4^(+)/CD8^(+)combined with modified clinical pulmonary infection score(mCPIS)and nu-tritional risk screening(NRS-2002)scale in predicting lung infection after thoracoscopic surgery for esophageal cancer.Methods To-tally 120 patients undergoing thoracoscopic surgery for esophageal cancer in The Third People's Hospital and The Second People's Hospital of Hengshui City from December 2020 to October 2021 were selected for a prospective cohort study.According to whether lung infection occurred during postoperative hospital stay,they were assigned into infected group and non-infected group.Logistic re-gression was used to construct a joint predictor model of lung infection status after thoracoscopic surgery for esophageal cancer,and a receiver operating characteristic curve(ROC)was drawn.Results CD4^(+)/CD8^(+)in the infected group was lower than that in the non-in-fected group[(0.78±0.14)vs.(1.06±0.18),P<0.05].The mCPIS and NRS-2002 scores in the infected group were higher than those of the non-infected group[(3.49±1.13)vs.(1.02±0.28),(10.89±2.18)vs.(6.22±2.49),respectively;P<0.05].The CD4^(+)/CD8^(+),mCPIS and NRS-2002 scores were all related factors affecting the occurrence of infection(P<0.05).The joint predictor model expression was pro-duced as follows:logit(P)=-5.007-0.702×X_(1)+1.832×X_(2)+1.934×X_(3).ROC analysis results showed that the AUC of the joint predictor for predicting infection was greater than the covariates,suggesting that the joint predictor prediction achieved the highest efficiency,the best cut-off value of the combined predictors was 0.11,and the prediction accuracy rate was 83.33%.Conclusions The CD4^(+)/CD8^(+),mCPIS and NRS-2002 scores are related to the incidence of pulmonary infection after thoracoscopic surgery for esophageal cancer.The combined predictors generated based on the three are expected to provide accurate reference information for clinical prediction of post-operative pulmonary infection risk.
作者
薛军英
王继超
张建华
王稳
XUE Junying;WANG Jichao;ZHANG Jianhua;WANG Wen(Lung Disease Division,The Third People's Hospital,Hengshui,Hebei 053000,China;Department of Cardio-Thoracic Surgery,The Second People's Hospital,Hengshui,Hebei 053000,China;The Orthopaedic Department,The Second People's Hospital,Hengshui,Hebei 053000,China)
出处
《安徽医药》
CAS
2024年第4期773-777,共5页
Anhui Medical and Pharmaceutical Journal
基金
衡水市重点研发计划(2020014033Z)。
