| 于宗平,高 鹏,彭新刚,吴昌亮,孙明辉.C反应蛋白、白细胞计数和T淋巴亚群与胃癌患者术后感染性并发症的关系及其诊断价值分析[J].,2020,(20):3923-3928 |
| C反应蛋白、白细胞计数和T淋巴亚群与胃癌患者术后感染性并发症的关系及其诊断价值分析 |
| The Relationship between C Reactive Protein, Leukocyte Count and T-lymphoid Subsets and Postoperative Infectious Complications of Gastric Cancer and Its Diagnostic Value |
| 投稿时间：2019-12-29 修订日期：2020-01-26 |
| DOI：10.13241/j.cnki.pmb.2020.20.027 |
| 中文关键词: 胃癌根治术 感染性并发症 C反应蛋白 白细胞计数 T淋巴亚群 |
| 英文关键词: Radical gastrectomy for gastric cancer Infectious complications C reactive protein White blood cell count T lymphocyte subsets |
| 基金项目:山东省医药卫生科技发展计划项目（2016WS1364） |
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| 中文摘要: |
| 摘要 目的：研究C反应蛋白（CRP）、白细胞计数（WBC）和T淋巴亚群与胃癌患者术后感染性并发症的关系，并分析其诊断价值。方法：以2016年3月～2018年6月于本院行根治术治疗的胃癌患者120例为研究对象，将其按照术后是否发生感染性并发症分为并发症组56例与无并发症组64例。分别比较两组患者术前、术后24 h以及术后48 h的血清CRP、WBC和T淋巴亚群相关指标水平变化情况。采用多因素Logistic回归分析胃癌感染性并发症的影响因素，采用受试者工作特征（ROC）曲线分析各项指标诊断胃癌根治术后感染性并发症的效能。结果：术后24 h、术后48 h两组患者血清CRP、WBC水平高于术前（P<0.05），且并发症组高于无并发症组（P<0.05）。术后48 h，并发症组CD3+、CD4+、CD4+/CD8+低于无并发症组（P<0.05），而手术前后CD8+无明显变化。多因素Logistic回归分析显示，年龄≥55岁、CRP≥10 mg/L、WBC≥10×109/L和CD4+/CD8+＜1是患者术后发生胃癌感染性并发症的危险因素（P＜0.05）。ROC曲线分析发现：CRP、WBC、CD3+、CD4+联合检测诊断胃癌根治术后感染性并发症的敏感度、特异度均高于单独检测。结论：CRP、WBC和T淋巴亚群与胃癌患者术后感染性并发症的发生密切相关，临床工作中对CRP、WBC、CD3+、CD4+进行联合检测有助于胃癌术后感染性并发症的早期诊断。 |
| 英文摘要: |
| ABSTRACT Objective: To study the relationship between C reactive protein (CRP), white blood cell count (WBC) and T lymphocyte subsets and postoperative infectious complications in patients with gastric cancer and analyze their diagnostic value. Methods: 120 patients with gastric cancer who were treated by radical operation in our hospital from March 2016 to June 2018 were selected as the research objects, according to whether there were infectious complications after operation, they were divided into complication group with 56 cases and non complication group with 64 cases. The level changes of serum CRP, WBC and T lymphatic subgroup related indexes were compared between the two groups before operation, 24 h and 48 h after operation. Multivariate Logistic regression analysis were used to analyze the influencing factors of infectious complications of gastric cancer, the effectiveness of various indicators in diagnosing postoperative infectious complications after radical gastrectomy was analyzed by using receiver operating characteristic (ROC) curves. Results: The levels of serum CRP, serum WBC at 24 h and 48 h after operation in the two groups were higher than before operation (P<0.05), the complication group were higher than the non complication group (P<0.05). 48 h after operation, the CD3+, CD4+, CD4+/CD8+ in the complications group were lower than that in the non complication group(P<0.05). There was no significant change in CD8+ before and after operation. Multivariate Logistic regression analysis showed that age greater than or equal to 55 years, CRP greater than or equal to 10 mg/L, WBC greater than or equal to 10×109/L and CD4+/CD8+ less than 1 were risk factor for postoperative gastric cancer infectious complications (P<0.05). The ROC curve analysis showed that the sensitivity and specificity of the combined detection of 4 indexes in diagnosing infectious complications after radical gastrectomy for gastric cancer were higher than that of separate detection. Conclusion: The changes of CRP, WBC and T lymphoid subgroup are closely related to Postoperative infectious complications in patients with gastric cancer, combined detection of CRP, WBC, CD3+, CD4+ in clinical work is helpful for early diagnosis of infectious complications of gastric cancer. |
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