摘要
目的 探讨血清基质金属蛋白酶-9(MMP-9)、可溶性髓系细胞触发受体-1(sTREM-1)、C反应蛋白(CRP)、降钙素原(PCT)水平联合应用对肺癌化疗并发细菌性肺部感染的诊断价值.方法 以2021年7月至2023年1月于我院进行化疗的97例肺癌患者为研究对象,根据化疗后是否发生细菌性肺部感染将患者分为感染组(43例)和未感染组(54例).比较两组、不同程度肺部感染患者血清MMP-9、sTREM-1、CRP、PCT水平,分析血清MMP-9、sTREM-1、CRP、PCT水平与发生肺部感染及PSI评分相关性、联合检测对肺癌化疗患者并发细菌性肺部感染的诊断价值.结果 与未感染组相比,感染组血清MMP-9、sTREM-1、CRP、PCT水平较高(P＜0.05);重度肺部感染患者血清 MMP-9、sTREM-1、CRP、PCT 水平＞中度患者＞轻度患者(P＜0.05);血清 MMP-9、sTREM-1、CRP、PCT 水平与发生肺部感染、PSI评分呈正相关(P＜0.05)受试者工作特征(ROC)曲线显示,血清MMP-9、sTREM-1、CRP、PCT水平联合诊断肺癌化疗患者并发细菌性肺部感染的AUC为0.807,最佳敏感度、特异度分别为93.02％、68.52％(P＜0.05).结论 血清MMP-9、sTREM-1、CRP、PCT水平肺癌化疗并发细菌性肺部感染者中呈高表达,随肺部感染加剧而升高,且联合应用时对于肺癌化疗患者并发症细菌性肺部感染的诊断价值较高,可为临床制定早期制定防治措施提供依据.
Abstract
Objective To explore the diagnostic value of serum matrix metalloproteinase-9(MMP-9),soluble myeloid cell triggering receptor-1(sTREM-1),C-reactive protein(CRP),and procalcitonin(PCT)levels combined in the diagno-sis of bacterial lung infection in lung cancer chemotherapy.Methods Ninety-seven lung cancer patients who underwent chemotherapy in our hospital from July 2021 to January 2023 were studied,and the patients were divided into infected(43)and uninfected(54)groups according to whether bacterial lung infection occurred after chemotherapy.To compare the ser-um MMP-9,sTREM-1,CRP and PCT levels at the time of admission between two groups and patients with different degrees of lung infection,and to analyze the correlation between the serum MMP-9,sTREM-1,CRP and PCT levels at the time of ad-mission and the occurrence of lung infection and PSI score,the factors influencing concurrent bacterial lung infection in lung cancer chemotherapy patients,and the diagnostic value of the combined test on concurrent bacterial lung infection in lung cancer chemotherapy patients.Results Compared with the uninfected group,serum MMP-9,sTREM-1,CRP,and PCT lev-els were higher in the infected group at admission(P＜0.05);serum MMP-9,sTREM-1,CRP,and PCT levels in patients with severe pulmonary infection at admission＞moderate patients＞mild patients(P＜0.05);serum MMP-9,sTREM-1,CRP,and PCT levels were positively correlated with the occurrence of pulmonary infection and PSI score(P＜0.05).Logis-tic regression analysis showed that serum MMP-9(＞118.33ng/L),sTREM-1(＞35.33pg/mL),CRP(＞53.28mg/L),and PCT(＞1.78ng/mL)levels at admission were risk factors for concomitant bacterial lung infections in lung cancer chemotherapy patients(P＜0.05).The subject operating characteristic(ROC)curve showed that the AUC of the combined serum MMP-9,sTREM-1,CRP,and PCT levels at admission for the diagnosis of concomitant bacterial lung infection in pa-tients undergoing chemotherapy for lung cancer was 0.807,with an optimal sensitivity and specificity of 93.02％and 68.52％,respectively(P＜0.05).Conclusion Serum MMP-9,sTREM-1,CRP,and PCT levels were highly expressed in patients with lung cancer chemotherapy complicated by bacterial lung infection,and increased with the intensification of lung infection,and were of high diagnostic value for lung cancer chemotherapy patients with complications of bacterial lung infec-tion when combined,which can provide a basis for clinical formulation of early formulation of prevention and control meas-ures.
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