晚期肺癌化疗肺部感染患者的病原学特点及HMGB1 MMP-9联合预测价值分析

doi:10.3969/j.issn.1006-6233.2025.05.09

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摘要 目的: 探讨晚期肺癌化疗患者肺部感染病原学特点及高迁移率族蛋白B1(HMGB1)、基质金属蛋白酶-9(MMP-9)联合预测价值。方法: 选择2023年6月至2024年6月空军军医大学第二附属医院收治的晚期肺癌化疗患者118例,根据化疗后是否发生肺部感染分为感染组(n=51)、未感染组(n=67)。收集感染组痰液标本进行病原学检查,同时比较两组HMGB1、MMP-9水平,Logistic回归分析晚期肺癌化疗患者肺部感染的影响因素,以受试者工作特征(ROC)曲线评价HMGB1联合MMP-9对晚期肺癌化疗肺部感染患者的预测价值。结果: 感染组中分离出革兰阴性菌39株(60.94%)、革兰阳性菌20株(31.25%)、真菌5株(7.81%);感染组HMGB1、MMP-9水平均高于未感染组(P<0.05);Logistic回归显示,HMGB1、MMP-9水平是肺部感染的危险因素(P<0.05);HMGB1的曲线下面积(AUC)为0.806,敏感度和特异度分别为56.86%、94.03%(P<0.05);MMP-9的AUC为0.838,敏感度和特异度分别为62.75%、92.54%(P<0.05);HMGB1联合MMP-9的AUC为0.905,敏感度和特异度分别为72.55%、92.54%(P<0.05)。结论: 晚期肺癌化疗患者的肺部感染以革兰阴性菌感染为主,且发生肺部感染的患者HMGB1、MMP-9水平会显著升高,通过联合HMGB1、MMP-9可提高临床对晚期肺癌化疗患者肺部感染的诊断效能。

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	张红佩
	金发光
	任腾

关键词 ：晚期肺癌化疗, 肺部感染, 病原学特点, 高迁移率族蛋白B1, 基质金属蛋白酶-9, 预测价值

Abstract：Objective: To investigate the etiological characteristics of pulmonary infection in patients undergoing chemotherapy for advanced lung cancer and the predictive value of high mobility group box 1 (HMGB1) combined with matrix metalloproteinase-9 (MMP-9). Methods: A total of 118 patients who underwent chemotherapy for advanced lung cancer in the Second Affiliated Hospital of Air Force Medical University from June 2023 to June 2024 were selected, and divided into the infected group (n=51) and the uninfected group (n=67) based on whether they developed pulmonary infection after chemotherapy. Sputum samples were collected from the infected group for etiological examination. The levels of HMGB1 and MMP-9 in the two groups were compared. Logistic regression analysis was performed to identify factors influencing pulmonary infection in patients undergoing chemotherapy for advanced lung cancer. The receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of HMGB1 combined with MMP-9 levels for pulmonary infection. Results: In this study, 51 patients developed pulmonary infection. A total of 64 strains of pathogenic bacteria were isolated, including 39 strains (60.94%) of Gram-negative bacteria, 20 strains (31.25%) of Gram-positive bacteria, and 5 strains (7.81%) of fungi. The levels of HMGB1 and MMP-9 in the infected group were higher than those in the uninfected group (P<0.05). Logistic regression analysis showed that HMGB1 and MMP-9 levels were risk factors for pulmonary infection (P<0.05). The area under the curve (AUC), sensitivity and specificity of HMGB1 were 0.806, 56.86% and 94.03% (P<0.05). The AUC, sensitivity and specificity of MMP-9 were 0.838, 62.75% and 92.54% (P<0.05). The AUC, sensitivity and specificity of HMGB1 combined with MMP-9 were 0.905, 72.55% and 92.54% (P<0.05). Conclusion: Gram-negative bacteria are main pathogenic bacteria of pulmonary infection in patients undergoing chemotherapy for advanced lung cancer. The levels of HMGB1 and MMP-9 are significantly elevated in patients with pulmonary infection. Combination of HMGB1 and MMP-9 can improve clinical diagnostic efficacy for pulmonary infection in patients undergoing chemotherapy for advanced lung cancer.

Key words： Chemotherapy for advanced lung cancer Pulmonary infection Etiological characteristic High mobility group box 1 Matrix metalloproteinase-9 Predictive value

基金资助:陕西省重点研发计划项目,(编号:20222DLSP01-10)

通讯作者: 任腾

引用本文:

张红佩, 金发光, 任腾. 晚期肺癌化疗肺部感染患者的病原学特点及HMGB1 MMP-9联合预测价值分析[J]. 河北医学, 2025, 31(5): 756-760.
ZHANG Hongpei, JIN Faguang, REN Teng. Etiological Characteristics of Pulmonary Infection in Patients Undergoing Chemotherapy for Advanced Lung Cancer and the Predictive Value of HMGB1 Combined with MMP-9. HeBei Med, 2025, 31(5): 756-760.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.05.09 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I5/756

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