| 刘京松,钱伟民,王 正,张 成,李 俊,周晓彤.肺癌胸腔镜术后肺部感染的危险因素探讨及术前CRP/Alb、PCT、SAA对感染风险的预测价值[J].,2023,(7):1358-1363 |
| 肺癌胸腔镜术后肺部感染的危险因素探讨及术前CRP/Alb、PCT、SAA对感染风险的预测价值 |
| Exploration of Risk Factors for Pulmonary Infection after Thoracoscopy Surgery for Lung Cancer and the Predictive Value of Preoperative CRP/Alb, PCT and SAA on the Risk of Infection |
| 投稿时间：2022-10-05 修订日期：2022-10-30 |
| DOI：10.13241/j.cnki.pmb.2023.07.031 |
| 中文关键词: 肺癌 胸腔镜手术 肺部感染 CRP/Alb PCT SAA 预测价值 |
| 英文关键词: Lung cancer Thoracoscopy surgery Pulmonary infection CRP/Alb PCT SAA Predictive value |
| 基金项目:江苏省自然科学基金项目（BK20150207） |
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| 中文摘要: |
| 摘要 目的：分析肺癌胸腔镜术后肺部感染的危险因素并探讨术前C反应蛋白/白蛋白比值（CRP/Alb）、降钙素原（PCT）、血清淀粉样蛋白A（SAA）对感染风险的预测价值。方法：选取2019年3月～2021年10月在徐州医科大学附属医院接受胸腔镜手术治疗的360例肺癌患者，根据肺癌胸腔镜术后72 h是否发生肺部感染分为肺部感染组57例和非肺部感染组303例。收集患者临床资料，术前1d检测患者血清CRP/Alb、PCT、SAA水平。通过单因素和多因素Logistic回归分析肺癌胸腔镜术后肺部感染的危险因素，受试者工作特征（ROC）曲线分析术前血清CRP/Alb、PCT、SAA水平对肺癌胸腔镜术后肺部感染的预测价值。结果：单因素分析显示，肺部感染组年龄≥60岁、吸烟史、糖尿病、手术时间≥3 h、术中出血量≥200 mL、机械通气时间≥12 h、胸腔引流时间≥5 d比例和血清CRP/Alb、PCT、SAA水平高于非肺部感染组（P＜0.05）。多因素Logistic回归分析显示，年龄≥60岁、吸烟史、糖尿病、手术时间≥3 h、机械通气时间≥12 h、胸腔引流时间≥5 d和血清CRP/Alb、PCT、SAA升高为肺癌胸腔镜术后肺部感染的独立危险因素（P＜0.05）。ROC曲线分析显示，术前血清CRP/Alb、PCT、SAA水平联合预测肺癌胸腔镜术后肺部感染的曲线下面积大于各指标单独预测。结论：年龄、吸烟史、糖尿病、手术时间、机械通气时间、胸腔引流时间和CRP/Alb、PCT、SAA升高为肺癌胸腔镜术后肺部感染的危险因素，术前血清CRP/Alb、PCT、SAA联合预测肺癌胸腔镜术后肺部感染的价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the risk factors for pulmonary infection after thoracoscopy surgery for lung cancer and to investigate the predictive value of preoperative C-reactive protein/albumin ratio (CRP/Alb), procalcitonin (PCT) and serum amyloid A (SAA) on the risk of infection. Methods: 360 patients with lung cancer who were treated by thoracoscopy surgery in the Affiliated Hospital of Xuzhou Medical University from March 2019 to October 2021 were selected, and they were divided into the pulmonary infection group with 57 cases and the non-pulmonary infection group with 303 cases according to whether pulmonary infection occurred 72 h after thoracoscopy surgery. Clinical data were collected from patients, and serum CRP/Alb, PCT and SAA levels of patients were detected 1 day before operation. Univariate and multivariate Logistic regression were used to analyze the risk factors of pulmonary infection after thoracoscopic surgery for lung cancer. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of preoperative serum CRP/Alb, PCT and SAA levels for pulmonary infection after thoracoscopic surgery for lung cancer. Results: Univariate analysis showed that the proportion of age≥60 years, smoking history, diabetes mellitus, operation time≥3h, intraoperative blood loss≥200 mL, mechanical ventilation time≥12 h, thoracic drainage time≥5 d, and serum CRP/Alb, PCT and SAA levels in the pulmonary infection group were higher than those in the non-pulmonary infection group (P<0.05). Multivariate Logistic regression analysis showed that age≥60 years, smoking history, diabetes mellitus, operation time≥3 h, mechanical ventilation time≥12 h, thoracic drainage time≥5 d and elevated serum CRP/Alb, PCT and SAA were independent risk factors for pulmonary infection after thoracoscopy surgery for lung cancer (P<0.05). ROC curve analysis showed that the area under curve of preoperative serum CRP/Alb, PCT and SAA combined in predicting pulmonary infection after thoracoscopy surgery for lung cancer was greater than that of each index alone. Conclusion: Age, smoking history, diabetes mellitus, operation time, mechanical ventilation time, thoracic drainage time and elevated CRP/Alb, PCT and SAA are risk factors for pulmonary infection after thoracoscopy surgery for lung cancer. The combined preoperative serum CRP/Alb, PCT and SAA have a high value in predicting pulmonary infection after thoracoscopy surgery for lung cancer. |
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