白血病中性粒细胞缺乏期伴感染患者中血清指标水平及其与细菌类型的关系  

Levels of serum indexs in leukemia patients suffering infection during neutropenia and their relationship with bacterial types

作　　者：郭靖 姜小建[1] 李红妮 GUO Jing;JIANG Xiaojian;LI Hongni(Department of Laboratory,Xi’an Central Hospital,Xi’an 710003,Shaanxi,China;Department of Laboratory,AVIC Xi’an Hospital,Xi’an 710077,Shaanxi,China)

机构地区：[1]西安市中心医院检验科,西安710003 [2]中航工业西安医院检验科,西安710077

出　　处：《癌症进展》2021年第21期2229-2232,共4页Oncology Progress

摘　　要：目的探讨血清超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)及免疫球蛋白(Ig)在白血病中性粒细胞缺乏期伴感染患者中的水平及其与细菌类型的关系。方法将160例白血病化疗后中性粒细胞缺乏期患者根据不同的感染情况分为感染组(n=70)和未感染组(n=90),检测血清中hs-CRP、PCT、IL-6及Ig水平。结果感染组患者血清hs-CRP、PCT和IL-6水平均明显高于未感染组(P﹤0.01),而IgA、IgG和IgM水平均明显低于未感染组(P﹤0.01)。70例感染组患者中共培养78株病原菌,其中革兰阴性菌患者血清hs-CRP和PCT水平均明显高于革兰阳性菌患者(P﹤0.01)。治疗后3、7天,感染组患者血清hs-CRP、PCT、IL-6水平均明显低于治疗前(P﹤0.01),而Ig A、IgG和IgM水平均明显高于治疗前(P﹤0.01)。hs-CRP和PCT鉴别革兰阴性菌感染的受试者工作特征(ROC)曲线下面积(AUC)分别为0.822和0.830,最佳截断值分别为12.50 mg/L和3.75 ng/ml,对应的灵敏度分别为85.50%和86.00%,特异度分别为82.00%和83.00%。结论白血病化疗后中性粒细胞缺乏期合并感染者hs-CRP、PCT、IL-6水平升高,而Ig水平降低,其中hs-CRP和PCT在鉴别革兰阳性菌和革兰阴性菌感染中具有一定的价值。Objective To investigate the levels of serum hypersensitive C reactive protein(hs-CRP),procalcitonin(PCT),interleukin 6(IL 6),and immunoglobulin(Ig)in leukemia patients suffering infection during neutropenia and their relationship with the types of bacteria.Method A total of 160 leukemia patients during neutropenia after chemo-therapy were divided into the infection group(n=70)and infection-free group(n=90)according to different infection conditions.The serum levels of hs-CRP,PCT,IL-6,and Ig were measured.Result The serum levels of hs-CRP,PCT,and IL-6 in the infection group were significantly higher than those in the infection-free group(P<0.01),while the levels of IgA,IgG,and IgM were significantly lower than those in the infection-free group(P<0.01).A total of 78 pathogenic bacteria were cultured from 70 patients in the infection group,among them,the serum hs-CRP and PCT levels of gramnegative bacteria patients were significantly higher than those gram-positive bacteria(P<0.01).Three and seven days after the treatment,the serum levels of hs-CRP,PCT,and IL-6 in the infection group were significantly lower than those before treatment(P<0.01),while IgA,IgG and IgM levels were significantly higher than those before treatment(P<0.01).The area under the receiver operating characteristic(ROC)area under the curve(AUC)of hs-CRP and PCT for the definition of gram-negative bacterial infections were 0.822 and 0.830,respectively,and the best cut-off values was 12.50 mg/L and 3.75 ng/ml,respectively,the corresponding sensitivity was 85.50%and 86.00%,and the specificity was 82.00%and 83.00%,respectively.Conclusion After leukemia chemotherapy,the levels of hs-CRP,PCT,and IL-6 in patients suffering infection during neutropenia increased,while the levels of Ig decreased,hs-CRP and PCT could have certain value in the distinguishment of grampositive bacteria and gram-negative bacteria infection.

关 键 词：超敏C-反应蛋白 降钙素原 白细胞介素-6 免疫球蛋白 白血病 中性粒细胞缺乏期 感染 

分 类 号：R733.7[医药卫生—肿瘤]