血清HMGB-1及PCT对食管癌患者手术后感染病情的评估效果研究

Research on evaluation effect of serum HMGB-1 and PCT on postoperative infection in patients with esophageal cancer

目的探讨血清高迁移率族蛋白-1(HMGB-1)及降钙素原(PCT)对食管癌患者手术后感染病情的评估效果。方法选取我院2017年2月～2018年5月收治的行根治性手术切除治疗后发生医院感染的食管癌患者136例为研究对象。依据APACHEⅡ评分评估病情程度,分为轻度组(APACHEⅡ评分10～29分,n=32)、中度组(APACHEⅡ评分30～49分,n=64)和重度组(APACHEⅡ评分50～71分,n=40)。患者入院后24h和感染确诊后24h内,采集静脉血5mL,检测PCT和HMGB-1。结果 136例食管癌患者感染后血清HMGB-1和PCT分别为(22.89±8.31)μg/L和(3.96±1.02)μg/L,均高于感染前,差异有统计学意义(P <0.05)。轻度组、中度组和重度组患者血清HMGB-1和PCT水平比较差异有统计学意义(P <0.05),中度组和重度组高于轻度组,且重度组高于中度组(P <0.05)。Spearman直线相关性分析显示,感染后血清HMGB-1(r=0.681)和PCT(r=0.692)水平与APACHEⅡ评分均呈明显正相关性(P <0.05)。结论检测血清HMGB-1和PCT水平可有效评估食管术后感染患者感染程度,对于指导临床治疗,争取最佳的治疗时机,具有十分重要的作用。

Objective To explore the evaluation effect of serum high mobility groupbox-1 protein(HMGB-1) and procalitonin(PCT) on postoperative infection in patients with esophageal cancer. Methods 136 patients with esophageal cancer who were treated and developed nosocomial infection after radical surgery in our hospital from February 2017 to May 2018 were selected as research objects. The condition of the disease was evaluated according to the APACHE II score.They were divided into the mild group(APACHE II score 10-29, n=32), moderate group(APACHE II score 30-49, n=64)and severe group(APACHE II score 50-71 points, n=40). Within 24 h after admission and 24 h after diagnosis of infection,5 ml of venous blood was collected and PCT and HMGB-1 were detected. Results The serum HMGB-1 and PCT of 136 patients with esophageal cancer were respectively(22.89±8.31)μg/L and(3.96±1.02)μg/L,which were higher than those before infection. The difference was statistically significant(P < 0.05).There were significant differences in serum HMGB-1 and PCT levels among the mild group, moderate group and severe groups(P < 0.05). The serum HMGB-1 and PCT levels of the moderate group and severe groupwere higher than that of the mild group and the severe group was higher than the moderate group(P < 0.05).Spearman linear correlation analysis showed that serum HMGB-1(r=0.681) and PCT(r=0.692)levels after infection were positively correlated with APACHE II scores(P < 0.05). Conclusion The detection of serum HMGB-1 and PCT levels can effectively assess the infectiousdegree of patients with esophageal cancer who develop postoperative infection. It has greatimportance for guiding clinical treatment and striving for the best treatment opportunity.