恶性肿瘤放化疗中心静脉导管置管患者血清HBP和pro-ADM水平在血流感染监测中的应用价值

Value of serum HBP and pro-ADM in monitoring of central venous catheter-related bloodstream infection of patients undergoing malignant tumor chemoradiotherapy

目的 探讨恶性肿瘤放化疗中心静脉导管置管患者血清肝素结合蛋白(HBP)、肾上腺髓质素前体(proADM)在血流感染监测中的价值。方法 选取2019年1月—2021年1月南通大学附属海安市人民医院恶性肿瘤放化疗治疗中心静脉导管置管后发生血流感染患者52例纳入感染组,未发生血流感染患者30例纳入未感染组,并将感染组患者依照其28 d内生存情况分为生存组37例、死亡组15例,比较不同组别血清HBP、pro-ADM表达水平,通过受试者工作特征(ROC)曲线评估血清指标对疾病预后的评估价值。结果 感染组血清HBP、pro-ADM水平高于未感染组(P<0.05);革兰阴性菌感染患者血清HBP水平高于革兰阳性菌感染患者(P<0.05);死亡组感染发生后第1天、第3天、第5天血清HBP、pro-ADM表达水平均高于生存组(P<0.05);感染发生后第3天、第5天血清HBP、pro-ADM联合预测患者预后状态ROC曲线下面积分别为0.840、0.852高于第1天的0.744(P<0.05)。结论 恶性肿瘤放化疗中心静脉导管置管发生血流感染患者血清HBP、pro-ADM水平升高,其动态监测对于患者预后评估具有重要价值。

OBJECTIVE To explore the values of serum heparin-binding protein(HBP)and pro-adrenomedullin(pro-ADM)in monitoring of central venous catheter-related bloodstream infection in the patients undergoing che-moradiotherapy.METHODS From Jan 2019 to Jan 2021,totally 52 patients who underwent malignant tumor che-moradiotherapy in Hai'an Hospital Affiliated to Nantong University and had central venous catheter-related blood-stream infection were assigned as the infection group,and 30 patients who did not have bloodstream infection were chosen as the no infection group.The patients of the infection group were divided into the survival group with 37 cases and the death group with 15 cases according to the 28-day survival status.The expression levels of serum HBP and pro-ADM were compared among the groups,and the value of the serological indexes in assessment of prognosis were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The levels of ser-um HBP and pro-ADM of the infection group were higher than those of the no infection group(P<0.05).The ser-um HBP level of the patients with gram-negative bacteria infection were higher than that of the patients with gram-positive bacteria infection(P<0.05).The expression levels of serum HBP and pro-ADM of the death group were higher than those of the survival group on the 1st,3rd and 5th day after the infection occurred(P<0.05).The area under ROC curve of the joint detection of serum HBP and pro-ADM was 0.840 on the 3rd day after the infection occurred,0.852 on the 5th day after the infection occurred,higher than 0.744 on the 1st day(P<0.05).CONCLUSION The patients who undergo the malignant tumor chemoradiotherapy and have central venous cathe-ter-related bloodstream infection show the rise of serum HBP and pro-ADM,and the dynamic monitoring has sig-nificant value in assessment of the prognosis.