预测结直肠肿瘤患者术后并发症的术前 C 反应蛋白和其他炎症生物标志物

IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Alternative therapies in health and medicine Pub Date : 2024-08-01
Yuchao Zhang, Guangyu Zhong, Kaihu Fan, Jialun He, Ying Sun, Linping Li
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引用次数: 0

摘要

研究目的本研究旨在探讨术前C反应蛋白(CRP)及其他炎症生物标志物:血小板与淋巴细胞比值(PLR)和中性粒细胞与淋巴细胞比值(NLR)对结直肠肿瘤患者术后并发症(感染、腹泻等)的预测价值:选取2021年1月至2022年12月在该院接受结直肠癌手术切除的109例结直肠肿瘤患者作为研究对象。对患者的术后并发症进行追踪,并将其分为并发症组和非并发症组。所有患者均接受术前生化检验。比较两组患者血清中 CRP、PLR 和 NLR 的水平。分析了这些指标与结直肠肿瘤患者术后并发症之间的关系。建立了逻辑回归模型来分析这些指标对术后并发症的影响,并绘制了接收者操作特征曲线(ROC)来评估预测值:109例结直肠肿瘤患者中,31例(28.44%)出现术后并发症。与非并发症组相比,并发症组的肿瘤直径更大,开腹手术比例更高(P < .05)。与非并发症组相比,并发症组的血清 CRP、PLR 和 NLR 水平更高(P < .05)。相关性分析表明,血清 CRP、PLR 和 NLR 值与结直肠肿瘤患者术后并发症呈正相关(r > 0,P < .05)。逻辑回归模型显示,高血清 CRP 水平(95%CI:1.253-2.503)、PLR(95%CI:1.005-1.041)和 NLR 值(95%CI:2.702-20.533)是结直肠肿瘤患者术后并发症的危险因素(OR>1,P < .05)。ROC 曲线显示,血清 CRP 水平、PLR 和 NLR 值对结直肠肿瘤患者术后并发症有一定的预测价值(AUC=0.811、0.789、0.870),当截断值分别设定为 5.400 mg/L、142.790 和 2.485 时,预测价值最佳,联合检测显示出更高的预测价值(AUC=0.913)。术后一周,患者的 CRP 水平、PLR 值和 NLR 值均显著低于术前(P < .05):结论:术前血清CRP、PLR和NLR值与结直肠肿瘤患者术后并发症密切相关,可用于预测结直肠肿瘤患者术后并发症的风险。在临床上,通过测量上述指标可实现对患者术后并发症的早期预测,从而采取适当的预防措施,如排毒和感染控制,改善患者预后。
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Preoperative C-reactive Protein and Other Inflammatory Biomarkers as Predictors of Postoperative Complications in Colorectal Tumor Patients.

Objective: This study aims to explore the predictive value of preoperative C-reactive protein (CRP) and other inflammatory biomarkers: platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) for postoperative complications (infection, diarrhea, etc.) in colorectal tumor patients.

Methods: A cohort of 109 colorectal tumor patients who underwent surgical resection for colorectal cancer at the hospital from January 2021 to December 2022 were selected as the research subjects. Patients' postoperative complications were tracked, and they were split into the complication group and the non-complication group. All patients underwent preoperative biochemical tests. Serum levels of CRP, PLR, and NLR were compared between the two groups. The relationship between these markers and postoperative complications in colorectal tumor patients was analyzed. A Logistic regression model was established to analyze their impact on postoperative complications, and a Receiver Operating Characteristic (ROC) curve was drawn to assess predictive value.

Results: Among the 109 colorectal tumor patients, 31 cases (28.44%) experienced postoperative complications. The complication group had larger tumor diameters and a higher proportion of open surgeries compared to the non-complication group (P < .05). Serum levels of CRP, PLR, and NLR were higher in the complication group compared to the non-complication group (P < .05). Correlation analysis showed that serum CRP, PLR, and NLR values were positively correlated with postoperative complications in colorectal tumor patients (r > 0, P < .05). The Logistic regression model revealed that high serum CRP levels (95%CI: 1.253-2.503), PLR (95%CI: 1.005-1.041), and NLR values (95%CI: 2.702-20.533) were risk factors for postoperative complications in colorectal tumor patients (OR>1, P < .05). The ROC curve demonstrated that serum CRP levels, PLR, and NLR values had certain predictive values for postoperative complications in colorectal tumor patients (AUC=0.811, 0.789, 0.870), the optimal predictive values were obtained when the cut-off values were set at 5.400 mg/L, 142.790, and 2.485, respectively and combined detection showed even higher predictive values (AUC=0.913). At 1 week post-surgery, the patient's CRP levels, PLR value, and NLR value were significantly lower than pre-surgery (P < .05).

Conclusion: Preoperative serum CRP, PLR, and NLR values are closely related to postoperative complications in colorectal tumor patients, and they can be used to predict the risk of postoperative complications in colorectal tumor patients. Clinically, early prediction of postoperative complications in patients can be achieved by measuring the aforementioned indicators, allowing for the implementation of appropriate preventive measures such as detoxification and infection control to improve patient outcomes.

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来源期刊
Alternative therapies in health and medicine
Alternative therapies in health and medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
0.90
自引率
0.00%
发文量
219
期刊介绍: Launched in 1995, Alternative Therapies in Health and Medicine has a mission to promote the art and science of integrative medicine and a responsibility to improve public health. We strive to maintain the highest standards of ethical medical journalism independent of special interests that is timely, accurate, and a pleasure to read. We publish original, peer-reviewed scientific articles that provide health care providers with continuing education to promote health, prevent illness, and treat disease. Alternative Therapies in Health and Medicine was the first journal in this field to be indexed in the National Library of Medicine. In 2006, 2007, and 2008, ATHM had the highest impact factor ranking of any independently published peer-reviewed CAM journal in the United States—meaning that its research articles were cited more frequently than any other journal’s in the field. Alternative Therapies in Health and Medicine does not endorse any particular system or method but promotes the evaluation and appropriate use of all effective therapeutic approaches. Each issue contains a variety of disciplined inquiry methods, from case reports to original scientific research to systematic reviews. The editors encourage the integration of evidence-based emerging therapies with conventional medical practices by licensed health care providers in a way that promotes a comprehensive approach to health care that is focused on wellness, prevention, and healing. Alternative Therapies in Health and Medicine hopes to inform all licensed health care practitioners about developments in fields other than their own and to foster an ongoing debate about the scientific, clinical, historical, legal, political, and cultural issues that affect all of health care.
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