骨髓瘤化疗合并感染患者血清炎性因子变化的临床意义  

Clinical Significance of Serum Inflammatory Cytokines in Patients with Myeloma Chemotherapy Combined with Infection

作　　者：宋春鸽[1] 杨晓煜[1] 马若巾[1] 王琰[1] 庞素蕾[1] 陈精予[1] 

机构地区：[1]郑州大学第五附属医院,450052

出　　处：《实用癌症杂志》2017年第8期1305-1308,共4页The Practical Journal of Cancer

摘　　要：目的探讨骨髓瘤化疗合并感染患者血清炎性因子水平变化。方法选取规范化疗的骨髓瘤患者100例,其中合并感染19例作为感染组,未感染的81例作为非感染组。于同期再选取健康体检者32例做对比研究,即对照组。检测和记录感染组、非感染组、健康体检组研究对象血常规(WBC计数)、超敏C反应蛋白(hs-CRP)和血清炎性因子水平(IL-1β、IL-6、IL-8、TNF-α)。比较3组研究对象IL-1β、IL-6、IL-8、TNF-α水平以及单一检测阳性率、联合检测阳性率,制作ROC曲线。结果 WBC计数水平,感染与非感染、健康体检组比较,差异无统计学意义(P>0.05)。hs-CRP,感染、非感染组高于健康体检组,差异有统计学意义(P<0.05);感染组与非感染组比较,差异无统计学意义(P>0.05)。IL-1β、IL-6、IL-8、TNF-α水平,感染组高于非感染、健康体检组,差异均有统计学意义(P<0.05)。感染组IL-1β、IL-6、IL-8、TNF-α单一检测及联合检测和IL-6、TNF-α联合检测阳性率高于非感染者,差异有统计学意义(P<0.05)。ROC曲线下最大面积时水平作为临界值,IL-1β为5.76 ng/L,IL-6为4.85 ng/L,IL-8为55.78 ng/L,TNF-α为13.35 ng/L。结论血清炎性因子水平变化可作为骨髓瘤化疗合并感染早期诊断指标,且有助于病情评价,尤其IL-6、TNF-α检测价值优于IL-1β、IL-8,二者联合检测优势更为突出。Objective To observe and study the changes of serum inflammatory cytokines in patients with myeloma chemotherapy combined with infection. Methods 100 patients with myeloma were enrolled in this study. 19 patients with infec- tion were infected group,81 cases without infection were non-infected group. 32 healthy subjects were selected as the control group. Hs-CRP and serum inflammatory cytokines（IL-1β,IL-6,IL-8,TNF-α） were measured and recorded in the infected group, non-infected group and healthy subjects. The positive rates of IL-1β, IL-6, IL-8 and TNF-α and the positive rate of single detection were compared and the ROC curve was made. Results There had no significant difference in WBC count between infected and non-infected and healthy subjects （P 〉 0.05 ）. Hs-CRP in infected patients, non-infected patients than healthy subjects, the differ- ence was statistically significant（P 〈 0.05 ）. There was no statistically significant difference between the infected patients and non-infected patients （P 〉 0. 05）. IL-1β, IL-6, IL-8 and TNF-α were higher than those of non-infected and healthy subjects, the difference was statistically significant（ P 〈 0.05 ）. The positive rate of IL-1β, IL-6, IL-8,TNF-α and IL-6 and TNF-α were higher than those of non-infected patients, the difference was statistically significant （P 〈 0.05 ）. IL-1β was 5.76 ng/L, IL-6 was 4.85 ng/L, IL-8 was 55.78 ng/L and TNF-α was 13.35 rig/L, the threshold was the highest in the ROC curve. Conclusion The changes of serum inflammatory cytokines can be used as early diagnosis of myeloma chemotherapy combined with early diagnosis and contribute to the evaluation of disease, especially IL-6, TNF-α detection value is better than IL-1β, IL-8, the two combined detection advantages to highlight.

关 键 词：骨髓瘤 化疗 感染 血清炎性因子 

分 类 号：R733.3[医药卫生—肿瘤]