乳腺癌根治术后感染对患者内环境的影响及急性时相反应蛋白表达特征分析

Effect of postoperative infection on internal environment of patients with radical mastectomy and expression of acute phase response protein in patients.

目的探究乳腺癌根治术后感染对患者内环境的影响与急性时相反应蛋白表达的变化及意义。方法收集2017年1月至2019年3月武汉市中心医院行乳腺癌根治术患者868例,共纳入169例进行回顾性分析。根据是否发生术后切口感染分为感染组(n=78)和未感染组(n=91),另选取同期健康体检者85例为对照组。观察3组研究对象血清中的细胞因子[肿瘤坏死因子-α(TNF-α)、干扰素-α(IFN-α)、白细胞介素(IL)-6、IL-2]、电解质指标(Na^(+)、K^(+)、Mg ^(2+)、Ca ^(2+))、急性时相反应蛋白指标[C-反应蛋白(CRP)、转铁蛋白(TF)、结合珠蛋白(HP)、α1-抗胰蛋白酶(α1-AT)]水平。结果感染组、未感染组TNF-α、IFN-α、IL-6、IL-2水平明显高于对照组,且感染组TNF-α、IFN-α、IL-6、IL-2水平明显高于未感染组,感染组、未感染组Na^(+)、K^(+)、Mg ^(2+)、Ca ^(2+)水平明显低于对照组,且感染组Na^(+)、K^(+)、Mg ^(2+)、Ca ^(2+)水平明显低于未感染组,差异均有统计学意义(P<0.05)。感染组、未感染组CRP、HP、α1-AT水平明显高于对照组,TF水平明显低于对照组,且感染组CRP、HP、α1-AT水平明显高于未感染组,TF水平明显低于未感染组,差异均有统计学意义(P<0.05)。结论乳腺癌根治术后感染影响患者机体内环境平衡,细胞因子、电解质、急性时相反应蛋白水平的异常表达可能参与术后感染,监测相应指标对术后感染的判断及控制具有重要价值。

Objective To investigate the changes and significance of the expression of the internal environment and acute phase response proteins in patients with post-treatment of breast cancer.Methods A total of 868 patients who underwent radical mastectomy from January 2017 to March 2019 in Wuhan central hospital were enrolled in this study.A total of 169 cases were retrospectively analyzed.According to whether the postoperative wound infection occurred,they were divided into the infected group(n=78)and the uninfected group(n=91),and 85 cases of healthy physical examination were selected as the control group.Three groups of cytokines[tumor necrosis factor-α(TNF-α),interferon-α(IFN-α),interleukin(IL)-6,IL-2],electrolyte index(Na^(+),K^(+),Mg^(2+),Ca^(2+)),acute phase-reactive protein indicators[C-reactive protein(CRP),transferrin(TF),haptoglobin(HP),α1-antitrypsin(α1-AT)]levels were observed.Results The levels of TNF-α,IFN-α,IL-6 and IL-2 in the infected group and the uninfected group were higher than those in the control group,and the levels of TNF-α,IFN-α,IL-6 and IL-2 in the infected group were higher than those in the uninfected group,the differences were statistically significant(P<0.05).The levels of Na^(+),K^(+),Mg^(2+),Ca^(2+)in the infected group and the uninfected group were lower than those in the control group,and the levels of Na^(+),K^(+),Mg^(2+),Ca^(2+)in the infected group were lower than those in the uninfected group,the differences were statistically significant(P<0.05).The levels of CRP,HP andα1-AT in the infected group and the uninfected group were higher than those in the control group,and the level of TF was lower than that in the control group,and the levels of CRP,HP andα1-AT in the infected group were higher than those in the uninfected group,the TF level was lower than the uninfected group,the differences were statistically significant(P<0.05).Conclusion The infection after radical mastectomy affects the balance of the patient's environment,and the abnormal expression of cytokines,electrolytes and acute phase-reactive protein may be involved in postoperative infection,It is of great value to monitor the corresponding indicators for the judgment and control of postoperative infection.