肺癌合并HAP患者炎症标志物的变化及临床意义

Determine the changes and significances of inflammatory markers in lung cancer patients complied with HAP

目的探讨肺癌合并医院获得性肺炎(Hospital-acquired pneumonia,HAP)患者血清炎症标志物的变化,评价其临床应用价值。方法选择收住我院确诊为肺癌的患者共80例,其中50例合并HAP者为感染组,另30例未合并HAP者为非感染组;感染组患者中30例经治疗临床症状改善、缓解者为感染控制组,另20例经治疗临床症状未能改善、缓解者为感染未控制组。分别采用免疫荧光法、双抗体夹心ELISA法、免疫比浊法检测患者血清降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及C反应蛋白(CRP)含量变化,SPSS 16.0软件分析数据。结果感染组血清PCT、IL-6、TNF-α及CRP含量均明显高于非感染组(P<0.01);感染控制与未控制组治疗前PCT、IL-6、TNF-α及CRP含量差异无统计学意义(P>0.05);治疗后,感染控制组血清PCT、IL-6、TNF-α及CRP含量明显降低(P<0.05,0.01),感染未控制组上述炎症标志物含量未见明显变化(P>0.05),两组间差异有统计学意义(P<0.01)。结论肺癌合并HAP患者血清炎症标志物含量明显升高,感染控制后上述指标明显下降,提示动态监测肺癌患者血清炎症标志物,尤PCT的含量变化,对肺癌合并HAP的诊断及临床疗效评估具有指导意义。

Objective To determine the changes of inflammatory markers in lung cancer patients complied with HAP, and evaluate the clinical application value. Methods Eighty patients with lung cancer hospitalized in our hospital were selected, fifty patients combined with HAP were selected as infection group, another thirty ones without HAP as non- infection group, thirty cases in the infection group get better after treatment as infection control group ,while another twenty ones have no improvement after treatment as infection un -control group.Test the levels of PCT, IL-6, TNF-ot and CRP of these patients by using immunofluorescence, ELISA, and immunoturbidimetry respectively, then analyze the data by SPSS 16.0 software. Results The concentrations of PCT, IL-6, TNF-α and CRP in infection group were significantly higher than those of patients in non-infection group （P〈0.01）. The values of PCT, IL-6, TNF-α and CRP in infection control group have no significant differences compared with those in the infection un-control group before treatment （P〉0.05）. After the treatment the values of these indicators decreased significantly in infection control group （P〈0.05,0.01） ,while the values of these unchanged in infection un-control group（ P〉0.05 ）.The difference between the two groups was statistically significant （P 〈 0. 05 ）. Conclusions The concentration of inflammatory markers in lung cancer patients combined with pneumonia increased significantly, but decreased significantly as the infection was controlled. The results indicated that dynamic monitoring the inflammatory markers, especially the concentration of PCT, plays an important role in diagnosis and evaluation patients with lung cancer combined with HAP.