乳腺癌术后肺部感染患者血清TNF-α、IL-6和PCT水平变化与肺功能的关系

Relationship between serum TNF-α,IL-6,PCT changes and lung function in patients with lung infection after breast cancer surgery

目的分析乳腺癌术后肺部感染患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和降钙素原(PCT)水平变化及与肺功能的关系,为临床乳腺癌根治术后感染的防治提供参考依据。方法选取2020年1月-2022年12月于南阳市中心医院行改良乳腺癌根治术的181例乳腺癌患者为研究对象,根据术后是否发生肺部感染将其分为感染组(n=34)和非感染组(n=147)。比较两组基线资料和手术前后血清TNF-α、IL-6、PCT水平及第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大通气量(MVV)和呼气峰值流速(PEF);Pearson相关性分析乳腺癌术后肺部感染患者TNF-α、IL-6、PCT水平与肺功能指标的关系。结果感染组年龄、合并糖尿病占比、吸烟史占比、肺部基础病史占比、术后引流时间、术后引流量、预防性使用抗生素占比和住院时间高于非感染组,差异均有统计学意义(χ^(2)=3.898、3.875、5.598、4.234、4.334、4.207、7.502、4.081,P均<0.05)。感染组术后血清TNF-α、IL-6、PCT水平高于非感染组,差异均有统计学意义(t=14.969、14.565、27.953,P均<0.05)。两组术后FEV1、FVC、MVV、PEF均低于术前,且感染组术后各指标低于非感染组,差异均有统计学意义(P均<0.05)。Pearson相关性分析显示,乳腺癌术后肺部感染患者TNF-α、IL-6、PCT水平与FEV1、FVC、MVV、PEF均成负相关(r=-0.513、-0.529、-0.405、-0.476,-0.427、-0.461、-0.390、-0.395,-0.309、-0.342、-0.454、-0.317,P均<0.001)。结论乳腺癌术后肺部感染患者血清TNF-α、IL-6、PCT水平升高,与肺功能成负相关。

Objective To explore the relationship between serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),procalcitonin(PCT)changes and lung function in patients with lung infection after breast cancer surgery.Methods A retrospective analysis was performed on the clinical case data of 181 patients with breast cancer undergoing modified radical mastectomy in the Nanyang Central Hospital between January 2020 and December 2022.According to presence or absence of postoperative lung infection,they were divided into infection group(34 cases)and non-infection group(147 cases).The baseline data,levels of serum TNF-α,IL-6 and PCT,forced expiratory volume in one second(FEV1),forced vital capacity(FVC),maximal voluntary ventilation(MVV)and peak expiratory flow(PEF)were compared between the two groups before and after surgery.The risk factors of lung infection after radical mastectomy were analyzed by logistic regression analysis,and the relationship between serum TNF-α,IL-6,PCT and postoperative lung function indexes was analyzed by Pearson correlation analysis.Results The age,proportions of diabetes mellitus,smoking history and basic lung disease history,postoperative drainage time,postoperative drainage volume,proportions of prophylactic antibiotics use and hospitalization time in infection group were significantly higher than those in non-infection group(t=3.898,3.875,5.598,4.234,4.334,4.207,7.502,4.081;all P<0.05).After surgery,levels of serum TNF-α,IL-6 and PCT in infection group were significantly higher than those in non-infection group(t=14.969,14.565,27.953;all P<0.05).After surgery,FEV1,FVC,MVV and PEF in both groups were decreased,which were significantly lower in infection group than noninfection group(all P<0.05).Pearson correlation analysis showed that TNF-α,IL-6 and PCT were negatively correlated with FEV1,FVC,MVV and PEF(r=0.513,0.529,0.476,0.427,0.461,0.390,0.395,0.309,0.342,0.454,0.317;all P<0.05).Conclusion The levels of serum TNF-α,IL-6 and PCT increase in patients with lung infection after breast cancer surgery,which were negatively correlated with postoperative lung function.