肝癌肝动脉化疗栓塞介入术后感染影响因素及其血清PCT与CRP和IL-8水平

目的探究肝癌肝动脉化疗栓塞(TACE)介入术后感染的影响因素及患者血清降钙素原(PCT)、C-反应蛋白(CRP),白细胞介素-8(IL-8)水平的变化。方法回顾性选取2017年1月-2019年12月于唐山市工人医院放射介入科行TACE治疗的肝癌患者360例为研究对象,根据是否发生术后感染,分为感染组30例和未感染组330例。收集两组的临床资料,比较两组血清炎症因子水平,归纳肝癌患者TACE术后感染的影响因素。结果肝癌TACE术后感染率为8.33%(30/360),感染部位以呼吸道、消化道、皮肤及软组织为主。感染组患者血清PCT、CRP、IL-8分别为(2.12±0.61)ng/ml、(57.67±20.12)ng/ml、(188.27±24.31)ng/ml,高于未感染组(P<0.001)。肝癌TACE术后感染单因素分析结果显示,血清PCT、CRP、IL-8水平、介入操作时间、抗菌药物使用、术中出血量对肝癌TACE患者术后感染有影响(P<0.05)。多因素Logistic回归分析结果显示,血清PCT>2 ng/ml、CRP>25 ng/ml、IL-8>160 pg/ml是肝癌TACE术后感染的影响因素(P<0.05)。结论 TACE术后感染患者血清PCT、CRP、IL-8水平呈高表达状态,血清PCT>2 ng/ml、CRP>25 ng/ml、IL-8>160 pg/ml为肝癌TACE术后感染的影响因素,临床应对高危患者进行密切监测,通过检测血清学指标以尽早判断是否出现术后感染,及时予以针对性措施进行治疗以降低术后感染率。

Influencing factors of infection after transcatheter arterial chemoembolization and changes of serum PCT,CRP and IL-8 levels in patients with hepatocellular carcinoma

OBJECTIVE To investigate the influencing factors of infection after transcatheter arterial chemoembolization(TACE) and the changes of serum procalcitonin(PCT), C-reactive protein(CRP) and interleukin-8(IL-8) levels in patients with liver cancer. METHODS Totally 360 patients with liver cancer underwent TACE treatment in the Department of Interventional Radiology of Tangshan Workers′ Hospital from Jan. 2017 to Dec. 2019 were retrospectively selected as the research subjects and divided into 30 cases of infected group and 330 cases of uninfected group according to whether postoperative infection occurred. The clinical data of the two groups were collected retrospectively, the levels of serum inflammatory factors in the two groups were compared, and the influencing factors of infection after TACE in patients with liver cancer were summarized. RESULTS The postoperative infection rate of liver cancer after TACE was 8.33%(30/360), and the infection sites were mainly the respiratory tract, digestive tract, skin and soft tissues. Serum PCT, CRP and IL-8 of patients in the infected group were(2.12±0.61)ng/ml,(57.67±20.12) ng/ml, and(188.27±24.31) ng/ml, respectively, which were significantly higher than those of patients in the uninfected group(P<0.001). The results of univariate analysis of postoperative infection of liver cancer after TACE showed that serum PCT, CRP, IL-8 levels, interventional operation time, use of antibacterial drugs, and intraoperative blood loss were the influencing factors of postoperative infection in patients with liver cancer TACE(P<0.05). The results of multivariate logistic regression analysis showed that serum PCT>2 ng/ml, CRP>25 ng/ml, IL-8>160 pg/ml were the influencing factors of postoperative infection of liver cancer after TACE(OR=1.206;1.379;1.240, P<0.05). CONCLUSION Serum PCT, CRP, and IL-8 levels in patients with infection after TACE were highly expressed. Serum PCT>2 ng/ml, CRP>25 ng/ml, and IL-8>160 pg/ml were the influencing factors of postoperative infection of liver cancer after TACE. High-risk patients should be closely monitored in clinical practice, serological indicators should be tested to determine whether postoperative infections occur as soon as possible, and targeted measures should be taken in time to reduce the postoperative infection rate.