胃癌患者围术期胃蛋白酶原和胃泌素-17变化对术后医院感染的影响

Influence of Postoperative Nososoial Infection on Perioperative Changes of Pepsinogen and Gastrin-17 in Patients with Gastric Cancer

目的探讨胃癌患者围术期胃蛋白酶原(PG)和胃泌素-17变化对术后医院感染的影响,为胃癌患者术后医院感染的防治提供参考。方法选取拟行胃癌手术治疗的患者150例(胃癌组),选取门诊同期行健康体检无异常者150例为对照(对照组),胃癌组在术前和术后7 d时、对照组在纳入研究时检测血清PG-Ⅰ和PG-Ⅱ、胃泌素-17水平,观察术后医院感染。结果胃癌组血清PG-Ⅰ和PG-Ⅱ、胃泌素-17分别为(73.94±11.65)ng/ml、(22.47±4.95)ng/ml、(15.58±7.77)pmol/l,明显高于对照组(P<0.05);胃癌组患者术后7 d时血清PG-Ⅰ和PG-Ⅱ、胃泌素-17分别为(65.23±10.21)ng/ml、(14.67±3.85)ng/ml、(8.76±4.47)pmol/l,明显低于术前(P<0.05)。术后共有23例发生医院感染,感染率为15.33%,分别为呼吸道感染11例、泌尿系感染5例、切口感染5例、胃肠道感染2例。术后感染患者术前血清PG-Ⅰ和PG-Ⅱ、胃泌素-17分别为(81.90±11.87)ng/ml、(26.40±4.23)ng/ml、(18.52±6.45)pmol/l,明显高于无感染患者(P<0.05);术后感染患者术后7 d时血清PG-Ⅰ和PG-Ⅱ、胃泌素-17分别为(69.15±10.12)ng/ml、(16.54±3.90)ng/ml、(11.73±4.58)pmol/l,明显高于无感染患者(P<0.05)。结论胃癌患者术后PG和胃泌素-17水平明显低于术前。术前PG和胃泌素-17水平较高患者术后更容易发生医院感染,同时术后感染患者PG和胃泌素-17水平下降幅度相对较小。

Objective To investigate the influence of postoperative nososoial infection on perioperative changes of pepsinogen(PG)and gastrin-17 in patients with gastric cancer,and provide reference for the prevention and treatment of postoperative nosocomial infection in patients with gastric cancer.Methods 150 cases patients who planned to undergo gastric cancer surgery(gastric cancer group)and 150 cases without abnormal physical examination in outpatient department at the same time(control group)were selected,serum PG-Ⅰ,PG-Ⅱ and gastrin-17 levels of the gastric cancer group in before and 7 days after surgery and the control group were included in the study,and observed postoperative nososoial infection.Results PG-Ⅰ were(73.94±11.65)ng/ml,PG-Ⅱ were(22.47±4.95)ng/ml,gastrin-17 were(15.58±7.77)pmol/l of the gastric cancer group higher than the control group(P<0.05).PG-Ⅰ were(65.23±10.21)ng/ml,PG-Ⅱ were(14.67±3.85)ng/ml,gastrin-17 were(8.76±4.47)pmol/l of 7 days after surgery lower higher than before surgery with gastric cancer group(P<0.05).23 cases patients were nosocomial infection,the infection rate were 15.33%,there were 11 cases of respiratory tract infection,5 cases of urinary tract infection,5 cases of incision infection and 2 cases of gastrointestinal tract infection.PG-Ⅰ were(81.90±11.87)ng/ml,PG-Ⅱ were(26.40±4.23)ng/ml,gastrin-17 were(18.52±6.45)pmol/l of postoperative infection patients higher than the non-infection patients in before surgery(P<0.05).PG-Ⅰ were(69.15±10.12)ng/ml,PG-Ⅱ were(16.54±3.90)ng/ml,gastrin-17 were(11.73±4.58)pmol/l of postoperative infection patients higher than the non-infection patients in after surgery(P<0.05).Conclusion Postoperative PG and gastrin-17 levels lower than those before surgery of patients with gastric cancer,and also closely related to postoperative nosocomial infection,the patients with higher preoperative PG and gastrin-17 levels are more likely to have hospital infection postoperatively.At the same time,PG and gastrin-17 levels in patients with postoperative infection decreased relatively little.