摘要
目的探讨血清降钙素原联合超敏C反应蛋白(hs-CRP)对非小细胞肺癌(NSCLC)手术患者术后细菌性肺部感染的诊断价值。方法根据术后细菌性肺部感染情况将80例NSCLC手术患者分为观察组(n=38)和对照组(n=42),观察组患者胸腔镜肺切除术后并发肺部感染,对照组术后未并发感染。统计术后并发肺部感染患者的病原菌分布情况。术前、术后24 h、术后3天,比较两组患者的血清hs-CRP和降钙素原水平;采用受试者工作特征(ROC)曲线和曲线下面积(AUC)评估术后48 h血清降钙素原、hs-CRP单独及联合检测诊断术后并发肺部感染的灵敏度、特异度;比较两组患者术后其他并发症(除肺部感染外)发生情况。结果80例胸腔镜肺切除术患者术后并发肺部感染38例,痰液培养分离出病原菌49株,革兰阳性菌26株和革兰阴性菌23株,其中肺炎链球菌占比最高,为38.78%。术后48 h、术后3天,两组患者的血清降钙素原和hs-CRP水平均高于本组术前,且观察组患者的血清降钙素原和hs-CRP水平均高于对照组患者,差异均有统计学意义(P﹤0.05)。降钙素原联合hs-CRP诊断NSCLC术后患者细菌性肺部感染的AUC为0.828,灵敏度为89.47%,均高于降钙素原或hs-CRP单独诊断的AUC、灵敏度(P﹤0.05)。两组患者术后乳糜胸、肺栓塞、急性呼吸窘迫综合征、皮下气肿、胸腔积液、声嘶发生率比较,差异均无统计学意义(P﹥0.05)。结论降钙素原、hs-CRP联合检测可有效提高NSCLC手术患者术后细菌性肺部感染的诊断价值。
Objective To explore the diagnostic value of serum procalcitonin combined with high-sensitivity C-reactive protein(hs-CRP)for postoperative bacterial lung infections in patients with non-small cell lung cancer(NSCLC)surgery.Method According to the complication of postoperative bacterial pulmonary infection,80 patients who underwent NSCLC surgery were divided into observation group(n=38)and control group(n=42),the observation group was complicated with pulmonary infection after thoracoscopic pneumonectomy,while the control group was not.The distribution of pathogens in patients with postoperative pulmonary infection was evaluated.The levels of serum hs-CRP and procalcitonin in the two groups were measured before operation,48 hours after operation and 3 days after operation.Receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to evaluate the sensitivity and specificity of serum procalcitonin and hs-CRP at 48 h after operation.The incidence of other postoperative complications(except pulmonary infection)was compared between the two groups.Result There were 38 patients with postoperative pulmonary infection.49 strains of pathogenic bacteria were isolated from sputum culture:26 strains of Gram-positive bacteria and 23 strains of Gram-negative bacteria,Streptococcus pneumoniae accounted for 38.78%.At 48 hours and 3 days after operation,the serum of procalcitonin and hs-CRP in the two groups were significantly higher than those before operation,and the serum procalcitonin and hs-CRP levels of the observation group were higher than those of the control group,and the differences was statistically significant(P<0.05).The AUC of procalcitonin combined with hs-CRP was 0.828,the sensitivity was 89.47%,which were higher than those of procalcitonin or hs-CRP alone(P<0.05).There was no significant difference between the two groups in the incidence of chylothorax,pulmonary embolism,acute respiratory distress syndrome,subcutaneous emphysema,pleural effusion and hoarseness(P>0.05).Conclusion The combin
作者
胡永强
罗爱华
HU Yongqiang;LUO Aihua(Department of Critical Care Medicine,the Fifth People’s Hospital of Xinjiang Uygur Autonomous Region,Urumchi 830026,Xinjiang,China)
出处
《癌症进展》
2020年第24期2527-2530,2558,共5页
Oncology Progress
关键词
非小细胞肺癌
肺部感染
降钙素原
超敏C反应蛋白
non-small cell lung cancer
pulmonary infection
procalcitonin
high-sensitivity C-reactive protein
