血管紧张素Ⅱ、去甲肾上腺素、醛固酮与非小细胞肺癌患者术后肺部感染的相关性分析

Correlation between angiotensin Ⅱ, norepinephrine, aldosterone and postoperative pulmonary infection in patients with non-small cell lung cancer

摘要:

目的 探讨非小细胞肺癌（NSCLC）术后肺部感染患者血管紧张素Ⅱ（Ang-Ⅱ）、去甲肾上腺素（NE）、醛固酮（ALD）水平及意义。方法 选取2019年4月—2021年12月石河子大学医学院第一附属医院收治的109例NSCLC术后患者为研究对象，根据NSCLC患者术后住院期间是否发生肺部感染分为研究组（术后肺部感染，34例）、对照组（术后未发生肺部感染，75例）。检测两组手术前后Ang-Ⅱ、NE、ALD及肺部感染指标的变化，分析研究组NSCLC患者术后Ang-Ⅱ、NE、ALD水平与术后肺部感染的相关性。结果 研究组患者手术前后Ang-Ⅱ、NE、ALD的差值大于对照组（P <0.05）。研究组患者年龄大于对照组（P <0.05），手术时间、术后机械通气时间长于对照组（P <0.05），Ang-Ⅱ、NE、ALD高于对照组（P <0.05）。多因素Logistic回归分析结果显示：年龄［O^R=6.341（95% CI：2.609，15.410）］、Ang-Ⅱ［O^R=3.662（95% CI：1.507，8.900）］、NE［O^R=3.846（95% CI：1.582，9.347）］、ALD［O^R=3.710（95% CI：1.526，9.016）］、术后机械通气时间［O^R=4.063（95% CI：1.672，9.875）］是NSCLC患者术后肺部感染的影响因素（P <0.05）。研究组患者手术前后降钙素原、C反应蛋白、白细胞计数的差值大于对照组（P <0.05）。Pearson相关性分析结果显示，研究组患者CRP水平与Ang-Ⅱ、NE、ALD呈正相关（r =0.718、0.638和0.582，P =0.000、0.029和0.033），WBC水平与Ang-Ⅱ、NE、ALD呈正相关（r =0.761、0.702和0.629，P =0.000、0.000和0.027）。结论 NSCLC患者术后肺部感染与Ang-Ⅱ、NE、ALD有关，Ang-Ⅱ、NE、ALD水平升高可能提示存在肺部感染。

Abstract:

Objective To investigate the effect of postoperative pulmonary infection on the levels of endocrine indicators angiotensin Ⅱ (Ang-Ⅱ), norepinephrine (NE) and aldosterone (ALD) in patients with non-small cell lung cancer (NSCLC) and their clinical significance.Methods A total of 109 NSCLC patients after surgery admitted to the First Affiliated Hospital of the Medical College of Shihezi University from April 2019 to December 2021 were enrolled. According to whether the NSCLC patients developed pulmonary infection during postoperative hospitalization, they were divided into study group (with postoperative pulmonary infection, 34 cases) and control group (without postoperative pulmonary infection, 75 cases). The changes of Ang-Ⅱ, NE, ALD and pulmonary infection indicators before and after operation in the two groups were determined. The relationship between postoperative Ang-Ⅱ, NE, and ALD levels and postoperative pulmonary infection in NSCLC patients in the study group was analyzed.Results The differences of Ang-Ⅱ, NE, and ALD before and after the operation in the study group were higher than those in the control group (P < 0.05). Compared with the control group, the age was older, the operative duration and the duration of postoperative mechanical ventilation were longer, and the levels of Ang-Ⅱ, NE, and ALD were higher in the study group (P < 0.05). The multivariable Logistic regression analysis showed that age [O^R= 6.341 (95% CI: 2.609, 15.410) ], Ang-Ⅱ level [O^R = 3.662 (95% CI: 1.507, 8.900) ], NE level [O^R= 3.846 (95% CI: 1.582, 9.347) ], ALD level [O^R= 3.710 (95% CI: 1.526, 9.016) ], and the duration of postoperative mechanical ventilation [O^R= 4.063 (95% CI: 1.672, 9.875) ] were the factors affecting the occurrence of postoperative pulmonary infection in patients with NSCLC (P < 0.05). The differences of procalcitonin (PCT) level, C-reactive protein (CRP) level, and white blood cell (WBC) count before and after the operation in the study group were greater than those in the control group (P < 0.05). Pearson correlation analysis showed that the level of CRP was positively correlated with the levels of Ang-Ⅱ, NE, and ALD (r =0.718, 0.638 and 0.582, P =0.000, 0.029 and 0.033), and the WBC count was also positively correlated with the levels of Ang-Ⅱ, NE, and ALD in the study group (P < 0.05).Conclusions The occurrence of postoperative pulmonary infection in NSCLC patients is related to endocrine indicators including Ang-Ⅱ, NE, and ALD. The increases in the levels of these indicators may contribute to the pulmonary infection.