血清相关指标的测定在肺癌合并肺部感染患者中的临床应用

Clinical application of Lac,PCT,and NLR assays in patients with lung cancer combined with lung infection

目的 探讨血乳酸(Lac)、中性粒细胞与淋巴细胞计数比值(NLR)、降钙素原(PCT)对肺癌合并肺部感染的诊断价值。方法 选取2020年4月至2023年1月于郑州大学第五附属医院诊治的126例肺癌患者为研究对象,其中合并肺部感染患者设为观察组(n=84),未合并肺部感染患者设为对照组(n=42)。比较两组临床特征、Lac、PCT、NLR水平。对比不同感染程度、不同病原菌感染类型患者Lac、PCT、NLR水平,分析其与临床特征、感染程度相关性。采用受试者工作特征曲线(ROC)分析各指标对肺癌合并肺部感染的诊断价值。结果 观察组Lac、PCT、NLR水平高于对照组,且与临床特征、感染程度密切相关(P<0.05);革兰阳性菌、革兰阴性菌患者Lac、PCT、NLR水平高于真菌患者,且革兰阳性菌患者高于革兰阴性菌患者(P<0.05);Lac、PCT联合NLR诊断肺癌合并肺部感染的AUC大于单独指标诊断(P<0.05)。结论 肺癌合并肺部感染患者血清Lac、PCT、NLR与感染病原菌种类、感染程度密切相关,联合检测其水平对肺部感染诊断具有临床应用价值。

Objective To investigate the diagnostic value of blood lactate(Lac),neutrophil-to-lymphocyte count ra⁃tio(NLR),and calcitoninogen(PCT)on lung cancer combined with lung infection.Methods One hundred and twen⁃ty-six lung cancer patients treated in our hospital from April 2020 to January 2023 were selected for the study,of which patients with combined lung infection were set as the observation group(n=84)and patients without combined lung in⁃fection were set as the control group(n=42).The clinical characteristics,Lac,PCT,and NLR levels were compared between the two groups.Lac,PCT,and NLR levels were compared in patients with different degrees of infection and different types of pathogenic bacterial infections,and their correlation with clinical characteristics and degree of infection was analyzed.The diagnostic value of each index for lung cancer combined with lung infection was analyzed using the subject operating characteristic curve(ROC).Results Lac,PCT,and NLR levels were higher in the observation group than in the control group,and were closely related to clinical characteristics and degree of infection(P<0.05);Lac,PCT,and NLR levels were higher in patients with Gram-positive bacteria and Gram-negative bacteria than in patients with fungi,and higher in patients with Gram-positive bacteria than in patients with Gram-negative bacteria(P<0.05);Lac and PCT combined with NLR for the diagnosis of lung cancer combined with lung infection AUC was greater than that diagnosed by indicators alone(P<0.05).Conclusion Serum Lac,PCT and NLR in patients with lung cancer combined with lung infection are closely related to the type of infecting pathogens and the degree of infec⁃tion,and the combined detection of their levels is of clinical application for the diagnosis of lung infection.