C-反应蛋白与清蛋白比值对微创食管癌患者术后感染的早期预测价值

Early predictive value of C-reactive protein to albumin ratio for postoperative infection in minimally invasive esophageal cancer

目的探讨C-反应蛋白与清蛋白比值对微创食管癌患者术后感染的早期预测价值。方法选取2015年10月至2018年10月间在云南省玉溪市人民医院心胸外科行微创食管癌手术的60例患者的临床资料进行回顾性分析,按照患者是否出现术后感染进行分组,未发生感染的46例患者纳入A组,发生感染的14例患者纳入B组。比较两组患者的年龄、性别等一般资料,通过单因素分析与多因素分析的方式筛选微创食管癌手术后感染的独立影响因素,计算C-反应蛋白与清蛋白比值(CAR)对微创食管癌术后感染的早期预测价值。结果患者的年龄、失血量和手术后3d时的CAR可能与微创食管癌手术后感染有关,差异均有统计学意义(均P <0. 05)。多因素分析结果显示,患者的年龄、失血量和手术后3d时CAR均为微创食管癌手术后感染的独立危险因素,差异均有统计学意义(均P <0. 05)。食管癌患者年龄、失血量和手术后3d时CAR对术后感染的预测价值进行计算,最佳截断值分别为63. 32岁、233. 63ml和4. 72,约登指数分别为43. 5%、29. 2%和56. 2%。结论 C-反应蛋白与清蛋白比值对微创食管癌术后感染有良好的早期预测价值,但是在实际临床工作中,还需要从患者的实际情况出发,进行综合考虑。

Objective To explore the early predictive value of C-reactive protein and albumin ratio( CAR) for postoperative infection in minimally invasive esophageal cancer. Methods A retrospective analysis of 60 patients undergoing minimally invasive esophageal cancer surgery at Yuxi People’s Hospital from October 2015 to October 2018 was conducted. According to whether the patient developed postoperative infection,patients were divided into the infection group( 14 patients) and non-infection group( 46 patients). General data including age were compared between the two groups. The independent factors influencing postoperative infection in minimally invasive esophageal cancer were screened by univariate analysis and multivariate analysis. Predictive value of CAR for postoperative infection in minimally invasive esophageal cancer was calculated. Results The age,blood loss,and postoperative 3d CAR were associated with postoperative infection in minimally invasive esophageal cancer( all P < 0. 05). Multivariate analysis showed that age,blood loss,and postoperative 3d CAR were independent factors influencing postoperative infection in minimally invasive esophageal cancer( all P < 0. 05). Using the age,blood loss,and postoperative 3d CAR to calculate the predictive value of postoperative infection in minimally invasive esophageal cancer,the optimal cutoff values were 63. 32 years,233. 63 ml and 4. 72,respectively,and the Yoden index was 43. 5%,29. 2% and 56. 2%,respectively. Conclusion The ratio of C-reactive protein to albumin has a good early predictive value for postoperative infection in minimally invasive esophageal cancer.However,in actual clinical work,it is necessary to proceed from the actual situation of the patient and make comprehensive considerations.