胃癌患者免疫功能及炎症水平的变化与腹腔镜术后发生医院感染的关系

The Relationship between Changes of Immune Function and Inflammation Level and Nosocomial Infection after Laparoscopic Surgery for Gastric Cancer

目的探讨胃癌患者免疫功能及炎症水平的变化与腹腔镜手术后发生医院感染的关系。方法选取腹腔镜手术治疗胃癌并发术后感染患者70例,同期未感染患者70例。检测感染患者血清中免疫细胞及炎症相关因子水平变化情况。结果感染组患者血清中CD3+、CD4+、CD8+、CD4+/CD8+水平明显低于未感染组(P<0.05);感染组患者血清中CRP和IL-6水平明显高于未感染组(P<0.05)。同时对感染组患者进行分析发现,感染率随CD4+水平下降呈显著上升趋势(P<0.05)。ROC分析显示:血清CRP、IL-6及CD4+对腹腔镜手术治疗胃癌后发生医院感染具有较高的预测诊断价值,ROC-AUC均在0.72以上,敏感度和特异度均高于0.7。结论胃癌患者免疫功能及炎症因子水平的变化与腹腔镜手术后发生医院感染有密切关系,对手术后发生医院感染有一定的预测诊断价值,因此,术后应密切关注患者免疫功能及炎症水平的变化,降低感染率。

Objective To investigate the relationship between the changes of immune function and inflammation level and nosocomial infection after laparoscopic surgery for gastric cancer.Methods 70 patients with gastric cancer complicated with postoperative infection were treated by laparoscopic surgery,70 patients without infection during the same period.The levels of immune cells and inflammatory related factors in serum of infected patients were detected.Results The levels of CD3+,CD4+,CD8+,CD4+/CD8+in the infected group were significantly lower than those in the control group(P<0.05),and the levels of CRP and IL-6 in the infected group were significantly higher than those of the control group(P<0.05).Conclusion The changes of immune function and inflammation level are closely related to nosocomial infection after laparoscopic surgery for gastric cancer.The changes of immune function and inflammation level should be paid close attention to after operation to reduce the infection rate.