不同细胞因子对儿童细菌性血流感染的早期诊断价值  

Value of Different Cytokines in Early Diagnosis of Bacterial Bloodstream Infection in Children

作　　者：朱雅琪 李思远 程阳 夏剑波[1] 丁进亚 ZHU Yaqi;LI Siyuan;CHENG Yang;XIA Jianbo;DING Jinya(Department of Clinical Laboratory,Maternal and Child Health Hospital of Hubei Province,Wuhan Hubei 430070,China)

机构地区：[1]湖北省妇幼保健院检验科,湖北武汉430070 [2]解放军武警总医院检验科 [3]中部战区总医院检验科

出　　处：《华南国防医学杂志》2022年第7期533-536,共4页Military Medical Journal of South China

摘　　要：目的探讨白细胞介素2(interleukin 2,IL-2)、IL-4、IL-6、IL-10、肿瘤坏死因子α(tumor necrosis factor alpha,TNF-α)、干扰素γ(interferon gamma,IFN-γ)在预测儿童细菌性血流感染(blood stream infection,BSI)早期诊断中的价值。方法回顾性分析IL-2、IL-4、IL-6、IL-10、TNF-α、IFN-γ在44例血培养阳性(BSI组)与147例血培养阴性(对照组)中的表达差异。结果BSI组IL-2、IL-4、IL-6、IL-10、TNF-α、IFN-γ表达水平与对照组比较差异均有统计学意义(P均<0.05)。TNF-α的受试者工作特征(receiver operating characteristic,ROC)曲线的曲线下面积(area under the curve,AUC)最低,为0.551(95%CI:0.457~0.645),诊断效能最低。IL-2的AUC最高,为0.725(95%CI:0.637~0.812),有较好的灵敏度(68.23%)和特异度(76.24%);IFN-γ、IL-6、IL-10均有较好的灵敏度和特异度,并且AUC均大于0.650,IL-4的特异度最高(81.59%),灵敏度只有50.01%。结论IL-2、IL-4、IL-6、IL-10、TNF-α、IFN-γ可作为诊断儿童细菌性BSI的有效补充,有助于临床早期诊断。Objective To investigate the value of interleukin 2(IL-2),IL-4,IL-6,IL-10,tumor necrosis factor alpha(TNF-α)and interferon gamma(IFN-γ)in predicting the early diagnosis of bacterial blood stream infection(BSI)in children.Methods The expression differences of IL-2、IL-4、IL-6、IL-10、TNF-α、IFN-γin44 positive(BSI group)and147 negative(control group)blood cultures were retrospectively analyzed.Results There were statistically significant differences among IL-2、IL-4、IL-6、IL-10、TNF-α、IFN-γin BSI group and the control group(all P<0.05).TNF-αhad the lowest area under the curve(AUC)of receiver operating characteristic(ROC)[AUC=0.551(95%CI:0.457-0.645)]and the lowest diagnostic efficacy.IL-2 had the highest AUC of 0.725(95%CI:0.637-0.812)and had good sensitivity(68.23%)and specificity(76.24%);IFN-γ,IL-6 and IL-10 showed good sensitivity and specificity,and the AUC was greater than0.650.IL-4 showed the highest specificity(81.59%)with sensitivity of only50.01%.Conclusion IL-2,IL-4,IL-6,IL-10,TNF-α,IFN-γcan be used as an effective supplement for diagnosing BSI in children and contribute to early clinical diagnosis.

关 键 词：细胞因子 血流感染 儿童 细菌性 敏感性 特异性 

分 类 号：R725[医药卫生—儿科]