老年脑胶质瘤患者术后疲乏与免疫炎性标志物水平的相关性研究

Correlation between postoperative fatigue and levels of immune and inflammatory markers in elderly patients with gliomas

摘要

目的 探究老年脑胶质瘤患者术后疲乏 (POF) 程度与免疫炎性标志物水平的相关性。方法 选取 2022 年 1 月—2024 年 9 月哈尔滨医科大学附属第一医院行手术治疗的 120 例老年脑胶质瘤患者为研究对象, 在术后第 7 天对其疲乏程度采用癌因性疲乏自评量表 (CFS) 评估, 根据评估结果将其分为轻度疲乏组 (CFS≤3 分) 45 例、中度疲乏组 (CFS 为 4 ~ 6 分) 50 例及重度疲乏组 (CFS≥7 分) 25 例。同时检测患者术后第 7 天血清免疫指标 [CD4 ⁺/CD8 ⁺T 细胞比值、自然杀伤细胞 (NK) 活性] 及炎性标志物 [C 反应蛋白 (CRP)、白细胞介素-6 (IL-6)]。采用 Pearson 相关分析不同疲乏程度组间的差异及相关性。结果 三组患者术后第 7 天血清 CD4 ⁺/CD8 ⁺T 细胞比值、NK 活性、CRP 及 IL-6 水平比较, 差异均有统计学意义 (P<0.05)。与轻度疲乏组比较, 中度疲乏组 CD4 ⁺/CD8 ⁺T 细胞比值、NK 活性更低, CRP、IL-6 水平更高, 差异有统计学意义 (P<0.05); 与轻度疲乏组、中度疲乏组比较, 重度疲乏组 CD4 ⁺/CD8 ⁺T 细胞比值、NK 活性更低, CRP、IL-6 水平更高, 差异有统计学意义 (P<0.05)。Pearson 相关分析显示, POF 评分与 CD4 ⁺/CD8 ⁺T 细胞比值和 NK 活性呈负相关 (P<0.05), 与 CRP 及 IL-6 水平呈正相关 (P<0.05)。结论 老年脑胶质瘤患者 POF 程度与免疫功能及炎性标志物水平密切相关, 其中 POF 程度越高, 患者免疫功能下降越明显, 炎性反应越显著。

Abstract

Objective To explore the correlation between the severity of postoperative fatigue (POF) and the levels of immune and inflammatory markers in elderly patients with gliomas. Methods A total of 120 elderly patients with gliomas who underwent surgery from January 2022 to September 2024 were enrolled in this study. The severity of postoperative fatigue was assessed using the Cancer-related fatigue self-rating scale (CFS) on the 7th postoperative day. According to the evaluation results, 45 patients were divided into mild fatigue group (CFS ≤ 3 points), 50 into moderate fatigue group (CFS 4 ~ 6 points) and 25 into severe fatigue group (CFS ≥ 7 points). Serum immune markers [CD4 ⁺/CD8 ⁺T cell ratio, natural killer cell (NK) activity] and inflammatory markers [C-reactive protein (CRP), interleukin-6 (IL-6)] were detected on the 7th postoperative day. Pearson correlation analysis was used to compare the differences and correlations among the three groups. Results On the 7th day after surgery, statistically significant differences were observed among the three patient groups in terms of serum CD4 ⁺/CD8 ⁺T cell ratio, NK activity, CRP levels, and IL-6 levels (P<0.05). Compared with the mild fatigue group, the moderate fatigue group had lower CD4 ⁺/CD8 ⁺T cell ratio, NK activity, and higher CRP and IL-6 levels, and the difference was statistically significant (P<0.05); compared with the mild fatigue group and the moderate fatigue group, the severe fatigue group had lower CD4 ⁺/CD8 ⁺T cell ratio, NK activity, and higher CRP and IL-6 levels, and the difference was statistically significant (P<0.05). Pearson correlation analysis showed that POF score was negatively correlated with CD4 ⁺/CD8 ⁺T cell ratio and NK activity (P<0.05) and positively correlated with CRP and IL-6 levels (P<0.05). Conclusion The severity of postoperative fatigue in elderly patients with gliomas is closely related to immune function and inflammatory markers. Patients with severe fatigue have significantly decreased immune function and increased inflammatory response.

关键词

脑胶质瘤 / 术后疲乏 / 免疫指标 / 炎性标志物

Key words

Glioma / Postoperative fatigue / Immune indicators / Inflammatory markers

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基金资助

^*国家自然科学基金(82473135)