摘要
目的 分析乳腺癌化疗患者外周静脉穿刺中心静脉置管(PICC)相关性血流感染外周血辅助性T细胞1(Th1)/Th2及其细胞因子水平变化.方法 选取2020年1月-2022年12月运城市中心医院收治的行PICC乳腺癌化疗患者为研究对象,根据是否发生PICC相关性血流感染,随机选取36例为感染组,114例为未感染组,比较两组患者外周血Th1/Th2及Th1类细胞因子[白细胞介素(IL)-2、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)]与Th2类细胞因子(IL-4、IL-6、IL-10)水平;绘制受试者工作特征(ROC)曲线分析外周血Th1/Th2及IL-2、TNF-α、IFN-γ、IL-4、IL-6、IL-10对乳腺癌化疗患者PICC相关性血流感染的预测价值.结果 两组导管留置时间及化疗次数比较差异有统计学意义(P＜0.05);感染组患者TNF-α、IL-4、IL-6、IL-10水平高于未感染组(P＜0.05),Th1/Th2、IL-2、IFN-γ 水平低于未感染组(P＜0.05);ROC 曲线分析显示,外周血 Th1/Th2、IL-2、TNF-α、IFN-γ、IL-4、IL-6、IL-10预测乳腺癌化疗后PICC导管相关性血流感染的曲线下面积(AUC)为0.896、0.803、0.944、0.649、0.744、0.978、0.946.结论 乳腺癌化疗后PICC导管相关性血流感染可能与外周血Th1/Th2失衡有关.
Abstract
OBJECTIVE To observe the changes of helper T cell(Th)1/Th2 and their cytokines in peripheral blood of the breast cancer chemotherapy patients with peripherally inserted central catheter(PICC)-associated blood-stream infection.METHODS The breast cancer patients who were treated with PICC and underwent chemotherapy in Shanxi Yuncheng Central Hospital from Jan 2020 to 2022 were recruited as the research subjects.According to the status of PICC-associated bloodstream infection,36 patients were randomly assigned as the infection group,and 114 patients were assigned as the no infection group.The levels of peripheral blood Th1/Th2,Th1 type cyto-kines[interleukin(IL)-2,tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)]and Th2 type cytokines(IL-4,IL-6,IL-10)were observed and compared between the two groups of patients.The values of the peripheral blood Th1/Th2,IL-2,TNF-α,IFN-γ,IL-4,IL-6 and IL-10 in prediction of PICC-associated bloodstream infection were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS There were significant differences in the catheter indwelling time and number of times of chemotherapy between the two groups(P＜0.05).The levels of TNF-α,IL-4,IL-6 and IL-10 of the infection group were significantly higher than those of the no infec-tion group(P＜0.05),the levels of Th1/Th2,IL-2 and IFN-γ of the infection group were significantly lower than those of the no infection group(P＜0.05).ROC curve analysis showed that the areas under curves(AUCs)of the peripheral blood Th1/Th2,IL-2,TNF-α,IFN-γ,IL-4,IL-6 and IL-10 were respectively 0.896,0.803,0.944,0.649,0.744,0.978 and 0.946 in prediction of PICC-associated bloodstream infection in the breast cancer pa-tients undergoing chemotherapy.CONCLUSION The PICC-associated bloodstream infection in the breast cancer patients undergoing chemotherapy may be associated with the imbalance of peripheral blood Th1/Th2.
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