肺癌术后肺部感染患者血浆sTREM⁃1、sCD163与PCT水平与疗效的关系

Relationship between plasma levels of sTREM⁃1,sCD163 and PCT in patients with lung infection after lung cancer surgery and curative effect

目的探讨肺癌术后肺部感染患者血浆可溶性髓样细胞触发受体⁃1(sTREM⁃1)、可溶性血红蛋白清道夫受体(sCD163)、降钙素原(PCT)水平变化及与治疗疗效的关系。方法选择2016年10月至2020年10月本院收治的85例肺癌术后发生肺部感染患者作为研究对象,纳入感染组。另择100例同期本院行肺癌手术未发生肺部感染患者作为对照,纳入非感染组。测定两组患者血浆sTREM⁃1、sCD163与PCT水平,评价感染组患者抗感染治疗效果。结果感染组患者共检出病原菌96例,其中革兰阳性菌72株(75.00%),革兰阴性菌22株(22.92%),真菌2株(2.08%)。感染组患者血清sTREM⁃1、sCD163、PCT水平显著高于非感染组,差异有统计学意义(P<0.05);血清sTREM⁃1、sCD163、PCT水平诊断肺部感染的曲线下面积分别为0.775、0.697、0.869,当截点值为34.80 pg/mL、121.06 pg/mL、1.30 ng/mL时约登指数最大。好转组患者血清sTREM⁃1、sCD163、PCT水平显著低于非好转组患者,差异有统计学意义(P<0.05);血清sTREM⁃1、sCD163、PCT水平预测肺部感染治疗效果的曲线下面积为0.681、0.734、0.735;当截点值为50.75 pg/mL、112.43 pg/mL、2.37 ng/mL时约登指数最大。结论肺癌术后肺部感染患者伴有血清sTREM⁃1、sCD163、PCT水平的明显升高,且其水平与患者治疗效果相关,临床可将其作为肺部感染诊断、疗效预测的指标。

Objective To explore the changes in levels of plasma soluble triggering receptor ex⁃pressed on myeloid cells⁃1(sTREM⁃1),soluble hemoglobin scavenger receptor(sCD163)and procalcitonin(PCT)in lung infection patients after lung cancer surgery and their relationship with the curative effect.Meth⁃ods A total of 85 patients with lung infection after lung cancer surgery(infection group)admitted to our hos⁃pital from October 2016 to October 2020 were selected.Another 100 patients without lung infection were in⁃cluded in the non⁃infection group.The plasma levels of sTREM⁃1,sCD163 and PCT in both groups were mea⁃sured.The effects of anti⁃infection treatment in infection group were evaluated.Results A total of 96 patho⁃genic bacteria were detected in patients in the infection group,including 72 gram⁃positive bacteria(75.00%),22 gram⁃negative bacteria(22.92%),and 2 fungi(2.08%).The serum levels of sTREM⁃1,sCD163 and PCT in the infected group were significantly higher than those in the non⁃infected group,and the difference was sta⁃tistically significant(P<0.05).The area under the curve(AUC)of serum sTREM⁃1,sCD163 and PCT for the diagnosis of lung infection were 0.775,0.697 and 0.869,respectively.When their cut⁃off values were 34.80 pg/mL,121.06 pg/mL and 1.30 ng/mL,the Youden index was the greatest.The levels of serum sTREM⁃1,sCD163 and PCT in the improved group were significantly lower than those in the non⁃improved group(P<0.05).The AUC values of serum sTREM⁃1,sCD163 and PCT for predicting curative effect on lung infection were 0.681,0.734 and 0.735,respectively.When their cut⁃off values were 50.75 pg/mL,112.43 pg/mL and 2.37 ng/mL,the Youden index was the largest.Conclusion The levels of serum sTREM⁃1,sCD163 and PCT are significantly increased in patients with lung infection after lung cancer surgery,and their levels are related to the curative effect.Clinically,they can be used as indicators for the diagnosis of lung infection and the predic⁃tion of curative effect.