Th1/Th2淋巴细胞因子及PCT检测在成人急性白血病感染中的诊断价值  

Diagnostic value of Th1/Th2 cytokines and PCT in adult acute leukemia

作　　者：陈燕 肖鸿文 熊皓 张惠桃 李晓明 CHEN Yan;XIAO Hongwen;XIONG Hao;ZHANG Huitao;LI Xiaoming(Department of Hematology,the Affiliated Hospital of Southwest Medical University,Sichuan Luzhou 646000,China;Department of Stem Cell Laboratory,the Affiliated Hospital of Southwest Medical University,Sichuan Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院血液内科,四川泸州646000 [2]西南医科大学附属医院干细胞实验室,四川泸州646000

出　　处：《现代肿瘤医学》2022年第21期3940-3944,共5页Journal of Modern Oncology

基　　金：西南医科大学青年基金项目(编号:2017-ZRQN-012);西南医科大学(泸州医学院)附属医院青年基金项目(编号:15045)。

摘　　要：目的:分析Th1/Th2淋巴细胞因子及PCT检测在成人急性白血病感染中的诊断意义,并分析不同病原菌感染患者Th1/Th2淋巴细胞因子及PCT结果是否存在差异,为临床工作中对急性白血病感染患者的有效抗感染治疗提供依据。方法:回顾性分析2020年05月至2020年12月之间我科收治的128例成人急性白血病患者感染情况、临床资料、Th1/Th2淋巴细胞因子及PCT结果,采用SPSS 25.0统计软件进行统计学分析。结果:128例急性白血病患者中,感染组97例,非感染对照组31例,其中26例血培养阳性;感染与非感染组IL-6、IL-10及PCT具有统计学差异(P<0.05),且感染组水平明显高于非感染组;IL-6、IL-10及PCT区分感染的ROC曲线做图得AUC分别为0.907、0.759及0.881;IL-10在G^(+)与G^(-)中存在差异(P<0.05),IL-10、IL-4与IFN-γ在真菌和G^(-)中存在差异(P<0.05),PCT、IL-4与IFN-γ在真菌和G^(+)中存在差异(P<0.05)。结论:IL-6、IL-10可作为成人急性白血病患者诊断感染除PCT外的参考指标,且通过ROC曲线可以看出,IL-6、IL-10对感染具有良好的预测意义。并且通过分析病原菌发现,IL-10、IL-4与IFN-γ将可能成为区分病原菌类型的良好指标。Objective:To analyze the diagnostic significance of Th1/Th2 cytokines and PCT in adult acute leukemia infection,and whether there are differences in Th1/Th2 cytokines and PCT of patients with different pathogen infection,so as to provide basis for effective anti infection treatment of patients with acute leukemia infection in clinical work.Methods:Retrospective analyzing patient's information from May 2020 to December 2020.Such as infection,clinical data,Th1/Th2 cytokines and PCT.The results of 128 adult patients with acute leukemia were analyzed by SPSS 25.0.Results:In 128 cases of acute leukemia patients,97 cases were infected group,31 cases were non infected control group,26 cases were positive in blood culture.There were significant differences in IL-6,IL-10 and PCT between infection group and non-infection group(P<0.05),and the level of IL-6,IL-10 and PCT in infection group was significantly higher than non-infection group.AUC of IL-6,IL-10 and PCT were 0.907,0.759 and 0.881.There were differences in G^(+)and G^(-)of IL-10(P<0.05).There were differences in fungi and G^(-)of IL-10,IL-4 and IFN-γ(P<0.05).There were differences in fungi and G^(+)of PCT,IL-4 and IFN-γ(P<0.05).Conclusion:IL-6,IL-10 can be used as a reference index for the diagnosis of infection in adult patients with acute leukemia except PCT,and it can be seen from the ROC curve that IL-6,IL-10 have good predictive significance for infection.And through the analysis of pathogenic bacteria,it is found that IL-10,IL-4 and IFN-γmay be good indicators to distinguish the types of pathogenic bacteria.

关 键 词：急性白血病 淋巴细胞因子 降钙素原 感染 

分 类 号：R733.71[医药卫生—肿瘤]