摘要
目的 探讨D-二聚体(D-D)、白细胞介素-2受体(IL-2R)、白细胞介素-33(IL-33)对恶性肿瘤患者化疗后并发脓毒症的预测价值。方法 选取160例恶性肿瘤化疗患者,根据其化疗后是否发生脓毒症分为脓毒症组(n=35)和非脓毒症组(n=125),比较两组患者的临床特征及D-D、IL-2R、IL-33水平。恶性肿瘤患者化疗后并发脓毒症的影响因素采用多因素Logistic回归分析;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估D-D、IL-2R、IL-33对恶性肿瘤患者化疗后并发脓毒症的预测价值。结果 脓毒症组年龄≥60岁、化疗周期≥2个、临床分期为Ⅲ~Ⅳ期、有侵入性操作、白细胞异常、合并糖尿病、住院时间≥30天、伴皮肤或黏膜溃疡患者比例均高于非脓毒症组,差异均有统计学意义(P﹤0.05)。脓毒症组患者D-D、IL-2R、IL-33水平均明显高于对照组,差异均有统计学意义(P﹤0.01)。多因素Logistic回归分析结果显示,年龄≥60岁、侵入性操作、合并糖尿病、D-D≥1.05 mg/L、IL-33≥13.61 pg/ml均是恶性肿瘤患者化疗后发生脓毒症的独立危险因素(P﹤0.05)。ROC曲线分析结果显示,D-D、IL-2R、IL-33预测恶性肿瘤患者化疗后发生脓毒症的AUC分别为0.854、0.896、0.904,其中IL-33的预测价值最高。结论 年龄≥60岁、侵入性操作、合并糖尿病、D-D≥1.05 mg/L、IL-33≥13.61 pg/ml均是恶性肿瘤患者化疗后发生脓毒症的独立危险因素,且D-D、IL-2R、IL-33对脓毒症的发生有一定的预测价值。
Objective To explore the predictive value of D-dimer(D-D),interleukin-2 receptor(IL-2R),and interleu-kin-33(IL-33)for sepsis in patients with malignant tumors after chemotherapy.Method A total of 160 patients with ma-lignant tumors after chemotherapy were selected and divided into sepsis group(n=35)and non-sepsis group(n=125)based on whether they developed sepsis after chemotherapy.The clinical characteristics and levels of D-D,IL-2R,and IL-33 were compared between the two groups.The influencing factors of sepsis in patients with malignant tumors after chemotherapy were analyzed by multivariate Logistic regression.The receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated,and the predictive value of D-D,IL-2R,and IL-33 for sepsis in pa-tients with malignant tumors after chemotherapy were evaluated.Result The proportion of patients with age≥60 years,chemotherapy cycle≥2,clinical stage III-IV,invasive operation,white blood cell abnormalities,diabetes,hospital stay≥30 days,and skin or mucosal ulcer in sepsis group were higher than those in non-sepsis group,and the differences were statistically significant(P<0.05).The levels of D-D,IL-2R,and IL-33 in sepsis group were significantly higher than those in non-sepsis group,and the differences were statistically significant(P<0.01).Multivariate Logistic regression analysis showed that age≥60 years,invasive operation,diabetes,D-D≥1.05 mg/L,IL-33≥13.61 pg/ml were independent risk fac-tors for sepsis in patients with malignant tumor after chemotherapy(P<0.05).The ROC curve analysis showed that the AUC of D-D,IL-2R,and IL-33 for predicting sepsis in patients with malignant tumors after chemotherapy were 0.854,0.896,and 0.904,respectively,and IL-33 had the highest predictive value.Conclusion Age≥60 years,invasive proce-dures,diabetes,D-D≥1.05 mg/L,IL-33≥13.61 pg/ml are independent risk factors for sepsis in patients with malignant tu-mor after chemotherapy,and D-D,IL-2R,IL-33 have certain predictive value for sepsis.
作者
李锦绣
赵云峰
牛杏果
王真真
LI Jinxiu;ZHAO Yunfeng;NIU Xingguo;WANG Zhenzhen(Department of Critical Care Medicine,2Department of Liver Transplantation,the Fifth Clinical Medical College of He’nan University of Chinese Medicine(Zhengzhou People’s Hospital),Zhengzhou 450003,He’nan,China)
出处
《癌症进展》
2024年第15期1701-1704,1709,共5页
Oncology Progress
基金
河南省医学科技攻关计划联合共建项目(LHGJ20230724)。
