IL-6与急性白血病化疗后发热的关系

Relation Between Interleukin 6 and Fever in Patients Undergoing Chemotherapy for Acute Leukemia

为了探讨白细胞介素6（IL－6）在预测急性白血病化疗后感染的作用，对28例接受化疗的急性白血病患者的44例次发热，采用ELISA法检测患者血浆IL－6浓度。结果发现有感染证据的病例的IL－6水平均有不同程度的增高，在发热首日，革兰氏阴性菌血症患者IL－6水平（中位值1964pg／ml，范围1053～20794pg／ml）较革兰氏阳性菌血症患者IL－6水平（中位值283pg／ml，范围91～1496pg／ml）显著增高（P＜0．001），不明原因发热患者IL－6水平也较肿瘤热或治疗相关发热者IL－6水平显著增高（P＜0．005）。实验表明，IL－6是一种可早期预测感染的敏感因子。IL－6检测将有助于急性白血病化疗后发热原因的判断。

In order to probe the effect of interleukin 6 (IL - 6) in detecting infection in patients with acute leukemia. 44 episodes of febrile neutropenia in 28 patients undergoing chemotherapy for acute leukemia were studied. Plasma concentrations of IL-6 analysis was per formed with ELISA. The result showed that plasma lev-els of IL-6 in all patients with infection were increased. On the day of admission,the IL- 6 values were signifi-cantly higher in gram-negative bacteremias (median 1964 pg/ml; range 1053~ 20794 pg/ml) as compared with gram -positive bacteremias (median 283 pg/ml; range 91 ~ 1496 pg/ml, P<0. 001). Patients with unexplained fever had significantly higher concentration of IL- 6 than patients with tumour-or therapy-related fever (P<0. 005). The results of this study suggest that IL- 6 is an earlier and more sensitive indicator in detecting infec-tion in febrile neutropenic patients with acute leukemia. The measurement of IL- 6 level may be helpful for the assessment of fever in these patients.