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中国临床研究英文版:2024,37(10):1542-1546
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多种血液学标志物预测肝癌切除术后感染的临床价值
(哈尔滨医科大学附属第一医院普外科,黑龙江 哈尔滨 150001)
Clinical value of multiple hematological markers to predict infection after hepatic carcinectomy
(Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China)
摘要
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Received:December 18, 2023   Published Online:October 20, 2024
中文摘要: 目的 探讨中性粒细胞淋巴细胞比值(NLR)、单核细胞淋巴细胞比值(MLR)等多种血液学标志物在肝癌切除术后感染中的预测价值。 方法 回顾性纳入2019年1月至2023年6月于哈尔滨医科大学附属第一医院接受肝癌切除术治疗的326例肝癌患者,根据术后住院期间是否发生感染,分为感染组72例(22.09%)和非感染组254例(77.91%)。采用多因素logistic回归法筛选肝癌患者术后感染的独立危险因素,采用ROC曲线分析各血液学指标预测肝癌患者术后感染的临床价值。 结果 多因素logistic回归分析结果显示,开放手术(OR=1.401, 95%CI: 1.043~1.881)、引流管放置时间>7d(OR=1.344, 95%CI: 1.052~1.718)以及PCT(OR=1.335, 95%CI: 1.005~1.773)、NLR(OR=1.554, 95%CI: 1.216~1.986)和营养控制状态(COUNT)评分(OR=1.465, 95%CI: 1.141~1.882)升高是肝癌切除术后感染的危险因素(P<0.05)。ROC曲线显示,NLR预测肝癌切除术后感染的效能最高(AUC=0.781),COUNT评分次之(AUC=0.675),PCT的预测效能最低(AUC=0.602)。 结论 PCT、NLR、CONUT评分均与肝癌切除术后感染具有相关性,对于术后感染具有一定预测能力,其中以NLR的预测价值相对最高。
Abstract:ObjectiveTo investigate the predictive value of multiple hematological markers in postoperative infection after hepatic carcinectomy, such as neutrophil to lymphocyte ratio (NLR) and monocyte to lymphocyte ratio (MLR). Methods A total of 326 hepatocellular carcinoma (HCC) patients received hepatectomy in the First Affiliated Hospital of Harbin Medical University from January 2019 to June 2023 were retrospectively included, and were divided into 72 cases (22.09%) in the infection group and 254 cases (77.91%) in the non-infection group, according to whether infection occurred during the postoperative hospitalization. Multivariate logistic regression was used to screen the independent risk factors for postoperative infections in HCC patients, and ROC curves were used to analyze the clinical value of each hematological marker in predicting postoperative infections in HCC patients. Results The results of multivariate logistic regression analysis showed that open surgery (OR=1.401, 95%CI: 1.043-1.881), drain placement time >7d (OR=1.344, 95%CI: 1.052-1.718), and increased PCT (OR=1.335, 95%CI: 1.005-1.773), NLR (OR=1.554, 95%CI: 1.216-1.986) and controlling nutritional status (COUNT) score (OR=1.465, 95%CI: 1.141-1.882) were risk factors for infection after hepatic carcinectonay (P<0.05). The ROC curves showed that NLR had the highest predictive value for infection after hepatic carcinectomy (AUC: 0.781), followed by COUNT score (AUC: 0.675) and PCT had the lowest predictive performance (AUC: 0.602). Conclusion PCT, NLR and CONUT scores are all correlated with postoperative infection after hepatic carcinectomy and have predictive ability for postoperative infection, with NLR having the relatively highest predictive value.
文章编号:     中图分类号:R735.7    文献标志码:A
基金项目:黑龙江省青年科学基金项目(QC2012C112)
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