摘要
目的 :研究中性粒细胞缺乏伴发热患者血浆中 IL - 6浓度和 C反应蛋白之间的关系 ,探讨 IL - 6在预测感染方面的作用。方法 :对 32例接受化疗的急性白血病患者的 5 0例次发热 ,采用 EL ISA法检测患者血浆 IL - 6浓度。结果 :有感染证据的病例 IL - 6水平均有不同程度的增高 ,且峰值较 C反应蛋白峰值提前 1d～ 3 d;在发热首日 ,革兰氏阴性菌血症患者 IL - 6水平 (中位数 195 2 ng/ L ,范围 10 5 3 ng/ L～ 2 0 794ng/ L )较革兰氏阳性菌血症患者 IL - 6水平 (中位数 2 83 ng/ L ,范围 91ng/ L～ 1496 ng/ L )显著增高 (P<0 .0 0 1)。不明原因发热患者 IL - 6水平也较肿瘤发热或治疗相关发热患者 IL - 6水平明显增高 (P<0 .0 0 5 )。结论 :IL - 6可作为早期预测感染的敏感指标 ,检测 IL - 6将有助于对急性白血病化疗后发热原因的判断。
Objective:To determine the relationship between plasma concentrations of interleukin 6 (IL 6) and C reaction protein (CRP)in febrile neutropenic patients with acute leukemia,and probe into the effect of IL 6 in detecting infection.Methods:50 episodes of febrile neutropenia in 32 patients undergoing chemotherapy for acute leukemia were included.IL 6 analysis was perfomed with ELISA .Results:Increased plasma levels of IL 6 were detected in all patients with infection.IL 6 values peaked 1-3 days before CRP values.On the day of admission,the IL 6 values were significantly higher in gram negative bacteremias (median 1952 pg/ml;range 1053-2079 pg/ml, P<0.001) .Patients with unexplained fever had significantly higher concentration of IL 6 than patients with tumour or therapy related fever (median 161 vs.36 pg/ml,P<0.005).Conclusion:IL 6 is an earlier and more sensitive indicator than CRP in detecting infection in neutropenic febrile patients with acute leukemia.The measurement of IL 6 level should be useful in the assessment of fever in these patients .
出处
《白血病》
2000年第4期217-220,共4页
