Predictive diagnosis value of peripheral blood inflammation index for infection after transcatheter arterial chemoembolization
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摘要: 目的 分析外周血炎症指标对肝动脉介入化疗栓塞术后感染的预测诊断价值,以期为该病的临床诊疗提供参考。 方法 纳入2015年1月-2017年10月在新疆维吾尔自治区人民医院接受肝动脉灌注化疗栓塞术治疗的原发性肝癌患者的临床资料。依据患者肝动脉灌注化疗栓塞术后是否发生感染分为感染组及未感染组。共计纳入感染组患者18例,未感染组患者96例。检测2组患者术后24 h外周血C-反应蛋白(CRP)、白介素-8(IL-8)及白介素-10(IL-10)水平。分析各指标对患者术后感染的预测诊断价值以及各指标间的相关性。 结果 感染组患者术后24 h外周血CRP水平显著高于未感染组患者[(26.5±5.2) mg/L vs. (19.7±4.6) mg/L,t=5.638,P<0.01];感染组患者术后24 h外周血IL-8水平显著高于未感染组患者[(39.6±7.3) ng/L vs. (16.9±3.8) ng/L,t=19.600,P<0.01]。2组患者术后24 h外周血IL-10水平比较差异无统计学意义[(16.1±4.6) ng/L vs. (17.3±5.2) ng/L,t=0.914,P=0.363]。ROC曲线分析显示,以22.14 ng/L为截点值,术后24 h外周血IL-8预测肝癌患者介入术后感染的敏感性为83.33%,特异性为89.58%,曲线下面积为0.926,优于CRP。肝癌患者介入术后24 h外周血CRP水平与IL-8水平呈现显著正相关关系(t=0.352,P<0.01)。 结论 肝癌患者术后24 h外周血炎症介质异常升高提示有感染的可能,其中IL-8对术后感染的预测诊断价值较高。Abstract: Objective To analyze the Predictive diagnosis value of peripheral blood inflammation index for infection after transcatheter arterial chemoembolization (TACE) and provide reference for clinical diagnosis and treatment of primary hepatic carcinoma. Methods The clinical data of primary hepatic carcinoma patients undergoing transcatheter arterial chemoembolization treatment in our hospital from 2015 to 2017 were analyzed. The patients were divided into two groups by postoperative infection, Group A:infection, n=18; Group B:without infection, n=96. The levels of CRP, IL-10 and IL-8 were tested and compared between the two groups at 24 hours after TACE. The infection predictive diagnosis value was analyzed by ROC. Results Twenty-four hours after TACE, Group A had higher level of CRP than that of Group B, the difference was statistically significant[(26.5±5.2) mg/L vs. (19.7±4.6) mg/L; t=5.638, P<0.01]; Group A had higher level of IL-8 after 24 h than that of Group B, the difference was statistically significant[(39.6±7.3) ng/L vs. (16.9±3.8) ng/L; t=19.600, P<0.01]; however, there was no significant difference in the level of IL-10 between the two group[(16.1±4.6) ng/L vs. (17.3±5.2) ng/L; t=0.914, P=0.363]. ROC analysis showed that the IL-8 for the prediction of infection after TACE using optimal cut-off point (22.14 ng/L) provided a sensitivity of 83.33% and a specificity of 89.58%, with an AUC of 0.926, which was better than these of CRP. Correlation analysis showed that, for Group A patients, the levels of CRP had significant positive correlation with IL-8 (t=0.352, P<0.01). Conclusion The level of IL-8 showed a well value of postoperative infection predictive diagnosis for primary hepatic carcinoma patients undergoing TACE.
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