浙江医学2018，Vol.40Issue(8)：817-819,823,4.DOI:10.12056/j.issn.1006-2785.2017.40.8.2018-44
老年肺癌化疗患者合并肺部感染影响因素分析
Complicated pulmonary infection in patients with advanced lung cancer after chemotherapy
金剑英 1朱延安 2郭群依 1金丹 1徐金印1
作者信息
- 1. 317000 浙江省台州医院肿瘤内科
- 2. 317000 浙江省台州医院急救中心
- 折叠
摘要
Abstract
Objective To investigate the risk factors,distribution of pathogen,and immune function in advanced lung cancer patients complicated with pulmonary infection after chemotherapy.Methods Total 203 patients with advanced lung cancer were enrolled in the study,among whom 26 cases were complicated with pulmonary infection (infection group) and 177 cases were not complicate with pulmonary infection (control group).The changes of immune function indexes in patients were determined and compared between two groups.The pathogenic bacteria in sputum culture in infection group were identified;the risk factors of complicated pulmonary infection in lung cancer patients were analyzed.Results Thirty seven bacterial strains were isolated,67.57％ were Gram-negative bacteria,29.73％ were Gram-positive bacteria and 2.70％ were fungi (P＜0.05).The levels of IgA,IgM and IgG in the infection group were significantly lower than those in the control group (P＜0.05).Compared with the control group the CD4+ level in infection group was decreased,CD8+ increased and the CD4+/CD8+ decreased significantly (P＜0.05).Non-conditional Logistic regression analysis showed that duration of chemotherapeutic＞2 weeks (HR=1.074,95％CI:1.102～8.397),atelectasis (HR=1.291,95％CI:1.124～8.310),WBC count ＜3.0 x 109/L after chemotherapy (HR=2.129,95％CI:1.501～5.306),albumin ＜30g/L after chemotherapy (HR=0.908,95％CI:0.351～0.973),physical condition score of 60～80 before chemotherapy (HR=1.210,95％CI:1.079～5.269) were risk factors of complicated pulmonary infection in patients with advanced lung cancer.Conclusion Gram-negative bacteria are the main pathogens of pulmonary infection in lung cancer patients.The immune function in patients complicated with pulmonary infection is decreased.The risk factors of pulmonary infection are duration of chemotherapy ＞2 weeks,atelectasis,WBC count ＜3.0 x 109/L,albumin ＜30g/L after chemotherapy,physical condition score 60～80 points before chemotherapy.关键词
肺癌/肺部感染/病原菌/免疫功能/危险因素Key words
Lung cancer/Pulmonary infection/Pathogenic bacteria/Immune function/Risk factors引用本文复制引用
金剑英,朱延安,郭群依,金丹,徐金印..老年肺癌化疗患者合并肺部感染影响因素分析[J].浙江医学,2018,40(8):817-819,823,4.
