摘要
目的探讨肺癌化疗期间感染情况及感染对外周血CD3^(+)、CD4^(+)、CD8^(+)和CD19^(+)淋巴细胞的影响。方法选取重庆市大足区人民医院2018年1月-2020年1月期间收治的肺癌患者254例为研究对象,收集所有患者临床资料,统计所有患者化疗期间感染例数,分析感染部位,并采集标本,进行病原菌培养及鉴定。分析感染组和未感染组外周血淋巴细胞亚群水平,化疗有效组和化疗无效组外周血淋巴细胞亚群水平,与化疗期间感染与化疗疗效的关系。结果 254例肺癌患者在化疗期间有43例感染,感染率为16.93%,感染部位以上呼吸道和下呼吸道感染例数最多;43例感染患者送检样本共分离病原菌38株,包括革兰阴性菌24株(63.16%),革兰阳性菌9株(23.68%),真菌5株(13.16%);感染与未感染患者在年龄、化疗周期、是否贫血、是否长期使用抗生素、是否有侵入性操作有关方面比较,差异有统计学意义(P<0.05);化疗后,感染组CD4^(+)水平、CD4^(+)/CD8^(+)、CD19^(+)水平均低于未感染组,差异有统计学意义(P<0.05);化疗有效组CD4^(+)水平、CD4^(+)/CD8^(+)、CD19^(+)水平均高于化疗无效组,差异有统计学意义(P<0.05);感染组化疗有效率明显低于未感染组,差异有统计学意义(P<0.05)。结论肺癌患者化疗期间易发生感染,感染会影响机体免疫功能,从而降低化疗疗效。
Objective To explore infection during lung cancer chemotherapy and its effects on CD3^(+),CD4^(+),CD8^(+)and CD19^(+)lymphocyte in peripheral blood.Methods A total of 254 patients with lung cancer who were admitted to the hospital from January 2018 to January 2020 were enrolled.The clinical data of all patients were collected.The number of infection cases during chemotherapy was statistically analyzed.The infection sites were analyzed.And specimens were collected for pathogen culture and identification.The levels of lymphocyte subsets in peripheral blood between infection group and noninfection group,between effective chemotherapy group and ineffective chemotherapy group,and relationship between infection and curative effect of chemotherapy during chemotherapy were analyzed.Results Of the 254 patients with lung cancer during chemotherapy,there were 43 cases with infection,with infection rate of 16.93%.The infected sites were mainly on upper and lower respiratory tract.Among detected specimens from 43 infection patients,there were 38 strains of pathogens,including 24 strains of Gram-negative bacteria(63.16%),9 strains of Gram-positive bacteria(23.68%)and 5 strains of fungi(13.16%).There were significant differences in age,chemotherapy cycle,anemia,long-term usage of antibiotics and invasive operation between infected patients and non-infected patients(P<0.05).After chemotherapy,levels of CD4^(+),CD4^(+)/CD8^(+)and CD19^(+)in infection group were lower than those in non-infection group(P<0.05).The levels of CD4^(+),CD4^(+)/CD8^(+)and CD19^(+)in effective chemotherapy group were higher than those in ineffective chemotherapy group(P<0.05).The response rate of chemotherapy in infection group was significantly lower than that in non-infection group(P<0.05).Conclusions Lung cancer patients were prone to infection during chemotherapy.And infection could affect body immune function,thus reducing curative effect of chemotherapy.
作者
昌建波
雷乘强
石帅
罗于海
CHANG Jian-bo;LEI Cheng-qiang;SHI Shuai;LUO Yu-hai(Department of Cardiothoracic Surgery,Chongqing Dazu People's Hospital,Dazu,Chongqing 402360,China)
出处
《热带医学杂志》
CAS
2021年第11期1457-1460,共4页
Journal of Tropical Medicine
基金
重庆市社会事业与民生保障科技创新专项项目(cstc2017shmsA130090)。
关键词
肺癌
化疗
感染
淋巴细胞亚群
Lung cancer
Chemotherapy
Infection
Lymphocyte subset
作者简介
昌建波(1984-),男,硕士,主治医师,研究方向:从事于肺癌方面的研究;通信作者:雷乘强,E-mail:646950974@qq.com。
