摘要
目的:探究系统性免疫炎症指数(systemic immune inflammation index,SII)与前白蛋白联合对肺癌术后肺部感染的预测价值。方法:回顾性分析2017年1月至2021年12月徐州医科大学附属医院胸外科收治的1025例行单一肺叶切除术的肺癌患者,根据术后是否感染分为感染组和非感染组,采用单因素和多因素Logistic回归分析肺癌术后发生肺部感染的危险因素;采用受试者工作特征(receiver operating characteristic,ROC)曲线分析SII与前白蛋白单独及联合对肺癌术后肺部感染发生的预测效能。结果:1025例肺癌患者中,108例(10.5%)术后出现肺部感染;与非感染组相比,感染组ASA分级、TNM分期、白细胞水平和SII值更高,合并糖尿病史更多,手术时间和肿瘤最大径更长,白蛋白和前白蛋白水平更低(P均<0.05);多因素Logistic回归分析显示,手术时间长、合并糖尿病、前白蛋白水平低、SII值高是肺癌术后肺部感染的独立危险因素(P<0.05);ROC曲线结果显示,SII曲线下面积(area under curve,AUC)为0.705(95%CI:0.656~0.755),前白蛋白AUC为0.626(95%CI:0.572~0.680);而SII联合前白蛋白预测肺部感染发生的AUC为0.751,优于单独对肺癌术后肺部感染的诊断预测价值(P<0.05)。结论:SII及前白蛋白可预测肺癌术后肺部感染的发生,两者联合诊断对肺部感染发生的预测价值更高。
Objective:To explore the predictive value of systemic immune inflammation index(SII)combined with prealbumin for postoperative pulmonary infection after lung cancer surgery.Methods:A retrospective analysis was performed on 1025 patients with lung cancer who underwent single lobectomy admitted to the Department of Thoracic Surgery,Affiliated Hospital of Xuzhou Medical University from January 2017 to December 2021.The patients were divided into infected group and non-infected group according to whether they were infected after surgery.The risk factors of postoperative lung infection were analyzed by univariate and multivariate Logistic regression.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of SII and prealbumin alone and in combination for postoperative lung infection.Results:Of the 1025 patients with lung cancer,108 cases(10.5%)developed pulmonary infection after surgery.Compared with the non-infected group,the infected group had higher ASA grade,TNM stage,leukocyte level and SII value,more patients with diabetes mellitus,longer operation time and maximum tumor diameter,and lower albumin and prealbumin levels(all P<0.05).Multivariate Logistic regression analysis showed that long operation time,combined diabetes mellitus,low prealbumin level and high SII value were independent risk factors for lung infection after lung cancer surgery(all P<0.05).ROC curve results showed that the area under curve(AUC)of SII was 0.705(95%CI:0.656-0.755),and the AUC of prealbumin was 0.626(95%CI:0.572-0.680);while the AUC of SII combined with prealbumin in predicting the occurrence of lung infection was 0.751,which was better than the value of single index in the diagnosis and prediction of postoperative lung infection after lung cancer surgery(P<0.05).Conclusion:SII and proalbumin could predict the occurrence of postoperative lung infection after lung cancer surgery,and the combination of SII and proalbumin has higher predictive value for the occurrence of lung infection.
作者
徐蔚
高甜甜
李明樾
刘祥峻
赵文静
XU Wei;GAO Tiantian;LI Mingyue;LIU Xiangjun;ZHAO Wenjing(Department of Anesthesiology,Affiliated Hospital of Xuzhou Medical University,Xuzhou Jiangsu 221006,China;Department of Critical Care Medicine,Affiliated Hospital of Xuzhou Medical University,Xuzhou Jiangsu 221006,China)
出处
《江苏大学学报（医学版）》
CAS
2023年第6期470-474,485,共6页
Journal of Jiangsu University：Medicine Edition
基金
徐州市科学技术局重点研发计划项目(KC20154)
徐州市科技局基金资助项目(KC16SY150)
吴阶平基金会恒瑞基金重点课题(HRJJ2018753)。
关键词
肺癌
系统性免疫炎症指数
前白蛋白
术后肺部感染
lung cancer
systemic immune inflammatory index
prealbumin
postoperative lung infection
