摘要
目的探讨白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)对急性白血病合并感染患儿预后的预测价值。方法选取168例急性白血病患儿,其中合并感染108例,未合并感染60例,分别作为感染组和对照组。比较两组患儿的IL-6、CRP及PCT水平,比较不同预后急性白血病合并感染患儿的IL-6、CRP及PCT水平。急性白血病患儿合并感染患儿预后的影响因素采用Cox回归分析。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),分析IL-6、CRP及PCT单独及联合检测对急性白血病合并感染患儿预后的预测价值。结果感染组患儿血清IL-6、CRP及PCT水平均明显高于对照组,差异均有统计学意义(P﹤0.01)。随访结束,预后良好74例,预后不良34例。预后不良急性白血病合并感染患儿血清IL-6、CRP及PCT水平均明显高于预后良好患儿,差异均有统计学意义(P﹤0.01)。多因素Cox回归分析结果显示,白细胞计数﹥10×10^(9)/L、未及时应用抗菌药物、置入外周中心静脉导管(PICC)、粒细胞减少时间﹥1周、发生黏膜炎、IL-6水平异常升高、CRP水平异常升高、PCT水平异常升高均是急性白血病合并感染患儿预后不良的独立危险因素(P﹤0.05)。IL-6、CRP、PCT联合检测预测急性白血病合并感染患儿预后的AUC为0.960(95%CI:0.921~0.999),此时的灵敏度、特异度分别为0.965、0.954,均高于各指标单独检测。结论IL-6、CRP、PCT水平在急性白血病合并感染患儿中水平较高,三者联合检测对急性白血病合并感染患儿的预后有较高的预测价值。
Objective To investigate the value of interleukin-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT)in predicting the prognosis of children with acute leukemia and infection.Method A total of 168 children with acute leukemia were selected,including 108 cases with co-infection and 60 cases without co-infection,as the infection group and the control group,respectively.The levels of IL-6,CRP and PCT were compared between the two groups,and the levels of IL-6,CRP and PCT in acute leukemia children with co-infection of differents prognosis were compared.Cox regression analysis was used to analyze the risk factors for the prognosis of children with acute leukemia combined and infection.The receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was calculated.The predictive value of combined detection of IL-6,CRP and PCT on the prognosis of children with acute leukemia and infection was analyzed.Result The levels of serum IL-6,CRP,and PCT in the infection group were significantly higher than those in the control group,and the differences were statistically significant(P<0.01).At the end of the follow-up,74 cases had well prognosis,and 34 cases had poor prognosis.The levels of serum IL-6,CRP,and PCT in acute leukemia children and infection with poor prognsis were significantly higher than those in children with well prognosis,and the differences were statistically significant(P<0.01).Multivariate Cox regression analysis showed that white blood cell count>10×10^(9)/L,antibiotics not used in time,peripherally inserted central venous catheter implantation,neutropenia time>1 week,mucositis,abnormally elevated IL-6 level,abnormal elevated CRP level,and abnormally elevated PCT level were independent risk factors for poor prognosis in children with acute leukemia and infection(P<0.05).The AUC of combined detection of IL-6,CRP,and PCT to predict the prognosis of patients with acute leukemia and infection was 0.960(95%CI:0.921-0.999),and the sensitivity and specificity at this time were 0.965 and
作者
卜凡丹
王刚
张娴
张晗
BU Fandan;WANG Gang;ZHANG Xian;ZHANG Han(Department of Pediatric Hematology and Oncology,Nanyang Central Hospital,Nanyang 473000,He’nan,China)
出处
《癌症进展》
2023年第7期754-757,共4页
Oncology Progress
