摘要
目的探讨白细胞介素-6(Interleukin-6,IL-6)、降钙素原(Procalcitonin,PCT)、激活素A(Activin-A,ACTA)对急性白血病患者化疗后粒细胞缺乏期感染的诊断价值。方法选择2016年3月-2019年1月海南医学院第一附属医院收治的急性白血病化疗后粒细胞缺乏期患者192例为研究对象。根据化疗后是否合并感染,将患者分为感染组80例和未感染组112例。比较两组患者血清IL-6、PCT、ACTA的表达水平。采用ROC曲线法和Logistic回归分析IL-6、PCT、ACTA对急性白血病患者化疗后感染的诊断价值。结果192例急性白血病患者化疗后发生医院感染80例,感染率为41.67%。感染部位以上呼吸道为主。80例感染患者共送检84个样本,分离病原菌96株,其中革兰阴性菌58株占60.42%,革兰阳性菌32株占33.33%,真菌6株占6.25%,以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和金黄色葡萄球菌为主;感染组血清IL-6、PCT、ACTA浓度分别为(7.23±2.01)ng/L、(2.68±1.08)ng/ml和(0.56±0.17)ng/ml,均高于未感染组(P<0.001)。ROC曲线分析结果显示,IL-6、PCT、ACTA预测感染的AUC分别为0.859、0.801和0.916。结论IL-6、PCT、ACTA早期诊断急性白血病化疗后粒细胞缺乏期感染有较高的价值,具有一定的临床价值。
OBJECTIVE To investigate the diagnostic value of interleukin-6(IL-6),procalcitonin(PCT)and activin A(ACTA)in post-chemotherapy granulocytopenia infection of patients with acute leukemia stage.METHODS From Mar.2016 to Jan.2019,192 patients with acute leukemia at the stage of granulocytopenia after chemotherapy admitted in the first affilicated hospital of Hainan medical college were selected as the study subjects,and were divided into 80 cases of the infection group and 112 casesof non-infection group according to whether they were co-infected after chemotherapy.The expression levels of serum IL-6,PCT and ACTA were compared between the two groups.ROC curve method and Logistic regression were used to analyze the diagnostic value of IL-6,PCT and activin-a in post-chemotherapy infection of patients with acute leukemia.RESULTS Totally 80 cases of nosocomial infection occurred in 192 patients with acute leukemia after chemotherapy,the infection rate was 41.67%.The main infection site was upper respiratory tract.A total of 84 samples were collected from 80 infected patients,and 96 strains of pathogenic bacteria were isolated,of which 58 strains of Gram-negative bacteria accounted for 60.42%,32 strains of Gram-positive bacteria accounted for 33.33%,6 strains of fungi accounted for 6.25%,dominated by Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus.The serum concentrations of IL-6,PCT and activin-a in the infection group were(7.23±2.01)ng/L,(2.68±1.08)ng/mL and(0.56±0.17)ng/mL,respectively,significantly higher than those in the non-infection group(P<0.001).The ROC curve analysis showed that the AUC predicted by IL-6,PCT and ACTA was 0.859、0.801 and 0.916,respectively.CONCLUSION The early diagnosis of IL-6,PCT and ACTA for the granulocyte deficiency infection in patients with acute leukemia after chemotherapy had higher value and certain clinical value.
作者
徐璐
苏群豪
王娇
陈瑜
吴肖志军
陶石
符才波
胡敏
李永富
XU Lu;SU Qun-hao;WANG Jiao;CHEN Yu;WU Xiao-zhijun;TAO Shi;FU Cai-bo;HU Min;LI Yong-fu(First Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570100,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第4期531-535,共5页
Chinese Journal of Nosocomiology
基金
海南省科研基金资助项目(2018368)。
