血清PCT及sTREM-1在肺癌术后并发细菌性肺部感染的诊断价值

Value of serum procalcitonin and soluble triggering receptor expressed on myeloid cells (sTREM-1) in diagnosis of postoperative bacterial pulmonary infection in lung cancer patients

目的探讨血清降钙素原(PCT)与髓样细胞触发受体-1(sTREM-1)对肺癌患者手术后并发细菌性肺部感染的诊断价值。方法选择医院2014年5月-2017年10月行手术治疗的214例肺癌患者为研究对象,按照患者是否在手术后出现肺部感染分为感染组与未感染组,对两组患者手术后24h血清C-反应蛋白(CRP)、乳酸、PCT和sTREM-1水平进行比较。ROC曲线分析4种指标对于患者手术后24h发生肺部感染的诊断价值。按照感染组患者治疗后是否出现好转分为好转组与未好转组,比较手术后24h(T1),出现感染时(T2)和感染后48h(T3)患者CRP、乳酸、PCT和sTREM-1水平变化。结果感染组患者手术后24h血清CRP、乳酸、PCT和sTREM-1水平均高于未感染组(P<0.05);PCT和sTREM-1指标的曲线下面积为0.884和0.971,诊断价值优于CRP和乳酸;好转组患者经过治疗后48h,CRP、乳酸、PCT和sTREM-1水平均出现降低,未好转组经过治疗后48h,CRP、乳酸、PCT和sTREM-1水平均持续增高。结论肺癌患者术后发生细菌性肺部感染的概率较高,降钙素原与髓样细胞触发受体-1对肺部感染的诊断价值较高。

OBJECTIVE To explore the value of serum procalcitonin(PCT)and soluble triggering receptor expressed on myeloid cells(sTREM-1)in diagnosis of postoperative bacterial pulmonary infection in lung cancer patients.METHODS A total of 214 lung cancer patients who received surgical procedures in hospitals from May 2014 to Oct 2017 were recruited as the study objects and divided into the infection group and the non-infection group according to the status of postoperative pulmonary infection.The levels of serum C-reactive protein(CRP),lactic acid,PCT and sTREM-1 were compared between the two groups of patients after the surgery for 24 hours,ROC curve analysis was carried out for the value of the 4 types of indexes in diagnosis of the pulmonary infection after the surgery for 24 hours.The patients of the infection group were divided into the improved group and the unimproved group according to the treatment outcomes,and the levels of CRP,lactic acid,PCT and sTREM-1 were observed and compared after the surgery for 24 hours(T1),when the patients had the infection(T2)and after the patients had the infection for 48 hours(T3).RESULTS The levels of serum CRP,lactic acid,PCT and sTREM-1 of the infection group were significantly higher than those of the non-infection group after the surgery for 24 hours(P<0.05),the areas under the curve of PCT and sTREM-1 were 0.884 and 0.971,respectively,and the diagnostic value of PCT and sTREM-1 was higher than that of CRP and lactic acid.The levels of CRP,lactic acid,PCT and sTREM-1 of the improved group were reduced after the treatment for 48 hours,while the levels of CRP,lactic acid,PCT and sTREM-1 of the unimproved group were continuously elevated after the treatment for 48 hours.CONCLUSION The incidence of postoperative bacterial pulmonary infection is high in the lung cancer patients,and the PCT and sTREM-1 have high value in diagnosis of the pulmonary infection.