CD64指数、su-PAR和IL-6在白血病化疗后粒细胞缺乏伴感染患者中的变化与意义  

Changes and significance of CD64 index,su-PAR,and IL-6 in patients with leukemia chemotherapy induced neutropenia and infection

作　　者：段宝英[1] 高溧鲜 黄文娇 张梅儒 万芳[1] DUAN Bao-ying;GAO Li-xian;HUANG Wen-jiao(Department of Hematology,Baiyin First People's Hospital,Baiyin Gansu 730900,China)

机构地区：[1]白银市第一人民医院血液科,甘肃白银730900

出　　处：《临床和实验医学杂志》2024年第23期2478-2482,共5页Journal of Clinical and Experimental Medicine

基　　金：甘肃省自然科学基金(编号:21JR1RA114);白银市科技计划项目(编号:2022-3-6Y)。

摘　　要：目的探讨白血病化疗后粒细胞缺乏伴感染患者外周血多型核白细胞簇分化抗原64(CD64)指数、可溶性尿激酶型纤溶酶原激活物受体(su-PAR)、白细胞介素-6(IL-6)的变化及其意义。方法采取回顾性研究方法,选取2022年8月至2023年8月在白银市第一人民医院血液科实施化疗后发生粒细胞缺乏伴感染的白血病患者50例作为感染组,另外选取59例白血病化疗后粒细胞缺乏但未出现感染的患者作为对照组。对比两组患者化疗前(T_(0))、化疗后粒缺期(T_(1))、感染组感染时(T_(2))的CD64指数、su-PAR水平和IL-6水平;采用受试者操作特征(ROC)曲线模型分析CD64、su-PAR、IL-6诊断白血病化疗后粒细胞缺乏伴感染的价值;并观察感染组不同血培养结果及治疗前后患者的CD64指数、su-PAR水平和IL-6水平变化。结果两组患者T_(1)、T_(2)时的CD64指数、su-PAR水平、IL-6水平均高于T_(0)时,差异均有统计学意义(P<0.05);感染组患者T_(1)、T_(2)时的CD64指数分别为36.18±5.50、46.28±7.84,su-PAR水平分别为(23.39±4.11)、(29.30±5.13)ng/mL,IL-6水平分别为(37.15±7.63)、(43.49±8.63)ng/L,均明显高于对照组[CD64指数:30.33±4.70、28.61±4.00;su-PAR:(19.63±3.85)、(18.26±3.55)ng/mL;IL-6:(29.82±5.86)、(27.30±6.61)ng/L],差异均有统计学意义(P<0.05)。CD64、su-PAR、IL-6及三项指标联合应用诊断白血病化疗后粒细胞缺乏伴感染的ROC曲线下面积值分别为0.794、0.734、0.629、0.914。感染组中,有21例患者血培养细菌感染为阳性、有29例患者血培养细菌感染为阴性。阳性患者的CD64指数、su-PAR水平、IL-6水平均显著高于阴性,差异均有统计学意义(P<0.05)。对白血病化疗后粒细胞缺乏伴感染患者给予抗感染治疗,在治疗第3天、第7天时,患者的CD64指数、su-PAR水平、IL-6水平均较治疗第1天显著降低,差异均有统计学意义(P<0.05)。结论白血病化疗后粒细胞缺乏伴感染患者外周血CD64指�Objective To explore the changes and significance of peripheral blood polymorphonuclear leukocyte cluster of differentiation 64(CD64)index,soluble urokinase-type plasminogen activator receptor(su-PAR)and interleukin-6(IL-6)in leukemia patients with granulocytopenia and infection after chemotherapy.Methods A retrospective study was conducted to select 50 leukemia patients with agranulocytosis and infection after chemotherapy in the Department of Hematology,Baiyin First People's Hospital from August 2022 to August 2023 as the infection group,and 59 leukemia patients with agranulocytosis but no infection after chemotherapy were selected as the control group.CD64 index,the levels of su-PAR and IL-6 in the two groups were compared before chemotherapy(T_(0)),after chemotherapy(T_(1)),and during infection(T_(2))in the infected group.The value of CD64,su-PAR and IL-6 in the diagnosis of agranulocytosis with infection after leukemia chemotherapy was analyzed using the receiver operating characteristic(ROC)curve model.And the changes of CD64 index,the levels of su-PAR and IL-6 in patients with different blood culture results in the infected group and before and after treatment were observed.Results The CD64 index,the levels of su-PAR and IL-6 at T_(1) and T_(2) in the two groups were higher than those at T_(0),and the differences were statistically significant(P<0.05).The CD64 index at T_(1) and T_(2) in the infection group were 36.18±5.50 and 46.28±7.84,su-PAR levels were(23.39±4.11)and(29.30±5.13)ng/mL,and IL-6 levels were(37.15±7.63)and(43.49±8.63)ng/L,respectively,which were significantly higher than those in the control group[CD64 index:30.33±4.70,28.61±4.00;su-PAR:(19.63±3.85),(18.26±3.55)ng/mL;IL-6:(29.82±5.86),(27.30±6.61)ng/L],the differences were statistically significant(P<0.05).The area under the curve of ROC of CD64,su-PAR,IL-6 and the combination of CD64,su-PAR and IL-6 were 0.794,0.734,0.629 and 0.914,respectively.There were 21 patients with positive blood culture bacterial infection and 29 patie

关 键 词：白血病 粒细胞缺乏 感染 白细胞介素-6 化疗 CD64指数 可溶性尿激酶型纤溶酶原激活物受体 

分 类 号：R73[医药卫生—肿瘤]