急性白血病化疗后中性粒细胞缺乏合并感染患者临床特征及血清免疫因子检测临床意义  

Clinical characteristics and clinical significance of serum immune factors in acute leukemia patients with post-chemotherapy neutropenia complicated with infection

作　　者：张海燕 唐岚 廖春淑[1] 罗源[1] 林晓静[2] ZHANG Haiyan;TANG Lan;LIAO Chunshu;LUO Yuan;LIN Xiaojing(Langzhong People’s Hospital,Langzhong 637400,China)

机构地区：[1]阆中市人民医院,四川阆中637400 [2]川北医学院附属医院,四川南充637000

出　　处：《陕西医学杂志》2024年第2期239-242,251,共5页Shaanxi Medical Journal

基　　金：四川省南充市社会科学研究项目(NC22B258)。

摘　　要：目的:分析急性白血病化疗后中性粒细胞缺乏合并感染患者临床特征及血清免疫因子检测的临床意义。方法:选取接受化疗治疗的132例急性白血病中性粒细胞缺乏患者,根据是否合并感染分为感染组和未感染组,另取同期体检健康者为对照组,比较三组受试者一般资料,分析感染患者的临床特征,检测三组受试者的血清免疫因子[免疫球蛋白A(IgA)、IgG、IgM]、炎症因子[C-反应蛋白(CRP)、降钙素原(PCT)、白介素-8(IL-8)]水平,采用ROC曲线分析IgA、IgG及IgM对急性白血病中性粒细胞缺乏合并感染的诊断价值。结果:74例中性粒细胞缺乏合并感染的急性白血病患者主要感染部位为呼吸道(71.62%),感染类型以细菌性感染为主(90.54%);74例感染患者共培养出87株病原菌,以革兰阴性菌为主(60.92%);感染组的IgA、IgG、IgM水平明显高于未感染组和对照组,且未感染组高于对照组(均P<0.05);感染组的CRP、PCT、IL-8水平明显高于未感染组和对照组,且未感染组高于对照组(均P<0.05);IgA、IgG、IgM水平诊断急性白血病患者中性粒细胞缺乏合并感染的AUC和截断值分别为0.827、2.31 g/L,0.921、13.87 g/L,0.834、1.56 g/L。结论:急性白血病中性粒细胞缺乏合并感染患者主要感染部位为呼吸道,并以革兰阴性菌占大多数;血清免疫因子IgA、IgG、IgM对急性白血病患者化疗后中性粒细胞缺乏合并感染有良好的诊断价值。Objective:To analyze the clinical characteristics and the clinical significance of serum immune factors in acute leukemia patients with post-chemotherapy neutropenia complicated with infection.Methods:A total of 132 patients with acute leukemia and neutropenia who received chemotherapy were selected and divided into infection group and non-infection group according to the presence or absence of infection.In the same period,healthy people were selected as the control group.The general data of the three groups were compared,and the clinical characteristics of the infected patients were analyzed.Serum immune factors(IgA,IgG,IgM)and inflammation factors(CRP,PCT,IL-8)levels were detected.ROC curve was used to analyze the diagnostic value of IgA,IgG and IgM in neutrophilic leukemia complicated with infection.Results:The main infection site of 74 acute leukemia patients with neutropenia and infection was respiratory tract(71.62%),and the main type of infection was bacterial infection(90.54%).A total of 87 strains of pathogenic bacteria were cultured from 74 patients with infection,mainly Gram-negative bacteria(60.92%).The levels of IgA,IgG and IgM in the infection group were significantly higher than those in the non-infection group and the control group,and the non-infection group was higher than the control group(all P<0.05).The levels of CRP,PCT and IL-8 in the infection group were significantly higher than those in the non-infection group and the control group,and the non-infection group was higher than the control group(all P<0.05).The AUC and cut-off values of IgA,IgG and IgM in the diagnosis of neutropenia and infection in patients with acute leukemia were 0.827 and 2.31 g/L,0.921 and 13.87 g/L,0.834 and 1.56 g/L,respectively.Conclusion:The main infection site of acute leukemia patients with neutropenia and infection is respiratory tract,and Gram-negative bacteria account for the majority.Serum immune factors IgA,IgG and IgM have good diagnostic value for acute leukemia patients with neutropenia and infection aft

关 键 词：急性白血病 化疗 中性粒细胞缺乏 感染 临床特征 免疫因子 

分 类 号：R733.71[医药卫生—肿瘤]