炎症因子及氧化应激指标在肝移植术后肺部感染预后预测中的价值被引量：3

Values of inflammatory factors and oxidative stress indexes in predicting the prognosis of pulmonary infection after liver transplantation

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摘要目的:分析炎症因子及氧化应激指标在肝移植术后肺部感染预后预测中的价值。方法:选取103例行肝脏移植术合并术后肺部感染患者为研究对象,根据预后不同分为死亡组(n=24)和存活组(n=79)。比较两组患者出现发热症状24 h内血清降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素(IL)-6、IL-10、肿瘤坏死因子(TNF)-α、超氧化物歧化酶(SOD)、丙二醛(MDA)水平;受试者工作特征(ROC)曲线分析炎症因子和氧化应激指标预测患者预后的价值。结果:死亡组患者血清PCT、IL-6、TNF-α、MDA水平高于存活组(P<0.05);血清IL-10、SOD水平低于存活组(P<0.05);两组患者血清CRP水平比较,差异无统计学意义(P>0.05)。ROC曲线分析显示,血清PCT、IL-6、TNF-α、MDA、IL-10、SOD水平预测患者预后的ROC曲线下面积(AUC)有统计学差异(P<0.05);其中,PCT的AUC最高,其次为TNF-α。在Cut-off值下,IL-6的预测灵敏度最高,PCT和SOD的预测特异度最高。结论:不同预后情况的肝移植术后肺部感染患者,在病程初期的血清炎症因子和氧化应激指标存在差异,临床医生可酌情综合应用辅助预后预测,并给予及时干预,改善预后。 Objective:To analyze the values of inflammatory factors and oxidative stress indexes in predicting the prognosis of pulmonary infection after liver transplantation.Methods:103 patients with postoperative pulmonary infection were selected as the research subjects.According to the prognosis,they were divided into the death group(n=24)and the survival group(n=79).The basic data and the serum levels of procalcitonin(PCT),C-reactive protein(CRP),interleukin(IL)-6,IL-10 and tumor necrosis factor(TNF)-α,superoxide dismutase(SOD)and malondialdehyde(MDA)within 24 hours of fever symptoms between the patients in the two groups were compared.The receiver operating characteristic(ROC)curve was used to analyze the values of inflammatory factors and oxidative stress indexes in predicting the prognosis of patients.Results:The serum PCT,IL-6,TNF-α,MDA of the patients in the death group were higher than those in the survival group,and the levels of serum IL-10 and SOD were lower than those in the control group.There was no significant difference in serum CRP between the two groups(P>0.05).ROC curve analysis showed that the areas under the ROC curve(AUCROC)of serum PCT,IL-6,TNF-α,MDA,IL-10 and SOD levels in predicting the prognosis of patients were statistically significant(P<0.05).Among them,the AUCROC of PCT was the highest,followed by TNF-α.Under the Cutoff value,the prediction sensitivity of IL-6 was the highest,and the prediction specificity of PCT and SOD was the highest.Conclusion:There are significant differences in serum inflammatory factors and oxidative stress indexes between the patients with pulmonary infection after liver transplantation with different prognosis.Clinicians can comprehensively use these indexes to assist prognosis prediction,and give timely intervention to improve the prognosis.

作者邹仁海谢艳玲田二云 ZOU Ren-hai;XIE Yan-ling;TIAN Er-yun(Department of Critical Medicine,Beijing Yuhe Rehabilitation Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 100143;Department of Critical Medicine,The Third Medical Center of PLA General Hospital,Beijing 100039,China;Department of Organ Transplantation,The Third Medical Center of PLA General Hospital,Beijing 100039,China)

机构地区北京裕和中西医结合康复医院重症医学科解放军总医院第三医学中心重症医学科解放军总医院第三医学中心器官移植科

出处《川北医学院学报》 CAS 2022年第4期486-489,共4页 Journal of North Sichuan Medical College

基金解放军总医院院内项目(ZH19022)。

关键词炎症因子氧化应激肝移植术后肺部感染预后预测 Inflammatory factors Oxidative stress Liver transplantation Postoperative pulmonary infection Prognosis prediction

分类号 R575.1 [医药卫生—消化系统]

作者简介邹仁海(1981-),男,主治医师。E-mail:zrhdoctor@163.com;通讯作者:田二云,E-mail:tianeryun@163.com。