摘要
目的探讨血清C-反应蛋白(CRP)、嗜酸性粒细胞(EOS)对结肠癌围手术期输血患者不良反应的预测价值。方法回顾性研究,采集郑州大学第五附属医院于2020年1月至2023年10月完成根治性切除术治疗的231例结肠癌患者资料,查阅患者资料,全部患者围手术期均接受常规输血治疗,输血治疗相关资料、就诊资料、实验室检查相关结果数据资料等均保存完整。仔细查阅患者资料,记录其围手术期输血不良反应发生情况,分为发生组与未发生组,设计资料记录表,通过医院电子病历系统,查阅患者资料后比较组间资料差异,记录围手术期输血开始前(入院时)实验室指标水平,重点分析血清CRP、EOS对患者围手术期输血不良反应发生的预测价值。结果231例结肠癌围手术期输血患者,发生输血不良反应23例,发生率为9.96%。发生组既往有输血史、过敏史占比高于未发生组,入院时血清CRP、EOS水平高于未发生组,差异有统计学意义(P<0.05)。经logistic回归分析,结果显示,结肠癌围手术期输血患者不良反应发生可能与患者既往有输血史、过敏史、术前血清CRP、EOS异常有关(P<0.05);绘制受试者工作特征(ROC)曲线,结果显示,术前血清CRP、EOS单独及联合预测结肠癌围手术期输血患者不良反应发生风险的曲线下面积(AUC)分别为0.768、0.741、0.821,均有一定预测价值。结论结肠癌围手术期输血患者输血不良反应的发生可能与术前血清CRP、EOS表达上调有关,术前检测患者血清CRP、EOS表达,可预测并筛选高风险人群,指导干预。
Objective To explore the predictive value of serum C-reactive protein(CRP)and eosinophils(EOS)on adverse reactions in perioperative blood transfusion patients with colon cancer.Methods A retrospective study was conducted to collect the data of 231 patients with colon cancer who underwent radical resection in the Fifth Affiliated Hospital of Zhengzhou University from January 2020 to October 2023.The data of patients were reviewed.All patients received routine blood transfusion during the perioperative period.The relevant data of blood transfusion treatment,treatment data,laboratory test results and other data were preserved intact.The patient’s data were carefully reviewed,and the occurrence of perioperative blood transfusion adverse reactions was recorded.The patients were divided into the occurrence group and the non-occurrence group.The data record table was designed.Through the hospital electronic medical record system,the data differences between the groups were compared after consulting the patient’s data.The laboratory index levels before the start of perioperative blood transfusion(on admission)were recorded,and the predictive value of serum CRP and EOS on the occurrence of perioperative blood transfusion adverse reactions was analyzed.Results Of the 231 patients with perioperative blood transfusion for colon cancer,23 had adverse reactions to blood transfusion,with an incidence of 9.96%.The proportion of previous blood transfusion history and allergy history in the occurrence group was higher than that in the non-occurrence group,and the serum CRP and EOS levels at admission were higher than those in the non-occurrence group,with a statistical significant difference(P<0.05).Logistic regression analysis showed that the occurrence of adverse reactions in patients with perioperative blood transfusion of colon cancer may be related to the patient’s previous history of blood transfusion,allergy history,preoperative serum CRP and EOS abnormalities(P<0.05).The receiver operating characteristic(ROC)curve was drawn.The results showed that the area under the curve(AUC)of preoperative serum CRP,EOS alone and combined in evaluating the adverse reactions of perioperative blood transfusion patients with colon cancer was 0.768,0.741 and 0.821,respectively,which had certain evaluation value,and the combined evaluation value was more ideal.Conclusion The occurrence of adverse reactions of blood transfusion in patients with colon cancer during perioperative period may be related to the up-regulation of preoperative serum CRP and EOS expression.Preoperative detection of serum CRP and EOS expression can predict and screen high-risk groups and guide intervention.
作者
杨璐
魏明
张宜花
YANG Lu;WEI Ming;ZHANG Yihua(Department of Blood Transfusion,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《河南医学研究》
2025年第16期3001-3005,共5页
Henan Medical Research
关键词
结肠癌
围手术期
输血不良反应
C-反应蛋白
嗜酸性粒细胞
预测
colon cancer
perioperative period
adverse reactions to blood transfusion
C-reactive protein
eosinophils
prediction
