基于术前CRP、PCT、IL-2水平构建胃癌根治术后感染风险预测模型

Based on the levels of CRP,PCT and IL-2 before operation,the risk prediction model of infection after radical gastrectomy of gastric cancer was established

目的探讨C-反应蛋白(C Reactive Protein,CRP)、血清降钙素原(Procalcitonin,PCT)、白细胞介素-2(Interleukin-2,IL-2)水平对胃癌根治术后感染的预测作用,并以此构建风险预测模型。方法前瞻性选取2019年6月-2022年7月在江西省丰城市人民医院收治的胃癌患者106例,均给予根治术治疗,统计患者术后发生感染情况,收集患者一般资料和基础疾病发生情况,在术前取患者的空腹静脉血检测CRP、PCT、IL-2水平。使用单因素、多因素Logistic回归分析患者的独立危险因素,并根据术前CRP、PCT、IL-2水平构建风险预测模型。结果106例行胃癌根治术患者中发生感染有27例(25.47%),Logistic回归分析结果显示,年龄、吸烟史、分化程度、置管时间、手术时间、合并糖尿病及术前血清CRP、PCT均是胃癌根治术后感染的独立危险因素,IL-2为独立保护因素(P<0.05),以三种血清学指标构建的风险预测模型为P(胃癌根治术后感染)=1/[1+EXP(5.005-0.642×CRP+1.559×PCT-0.843×IL-2)]。结论术前血清CRP、PCT水平在胃癌根治术后感染患者中表达水平较高,IL-2水平较低,使用三种血清学指标构建的风险预测模型可为患者行胃癌根治术后预防感染提供依据。

Objective To explore the predictive role of C-reactive Protein(CRP),serum Procalcitonin(PCT)and Interleukin-2(IL-2)levels on infection after radical gastric cancer surgery,and build a risk prediction model based on this.Methods A total of 106 patients with gastric cancer admitted to our hospital from June 2019 to July 2022 were prospectively selected,all of whom were given radical surgical treatment.Postoperative infection of the patients was statistically analyzed,general information and incidence of underlying diseases of the patients were collected,and fasting venous blood of the patients was collected before surgery to detect CRP,PCT and IL-2 levels.Univariate and multifactorial Logistic regression were used to analyze independent risk factors of patients,and risk prediction models were constructed according to preoperative CRP,PCT,and IL-2 levels.Results Infection occurred in 27(25.47%)of 106 patients undergoing radical gastrectomy.Logistic regression analysis showed that age,smoking history,degree of differentiation,catheterization time,operation time,diabetes mellitus,preoperative serum CRP and PCT were independent risk factors for postoperative gastrectomy infection.IL-2 was an independent protective factor(P<0.05),and the risk prediction model built with three serological indexes was P(infection after radical gastritis)=1/[1+EXP(5.005-0.642×CRP+1.559×PCT-0.843×IL-2)].Conclusion The levels of serum CRP and PCT before surgery are higher in patients with infection after radical gastrectomy,while the level of IL-2 is lower.The risk prediction model constructed by using three serological indexes can provide a basis for the prevention of infection after radical gastrectomy.