急性白血病感染患者血清炎性因子与免疫功能变化研究

Changes of serum inflammatory cytokines and immune function of acute leukemia patients with infection

目的探讨急性白血病(AL)感染及弥漫性血管内凝血(DIC)患者血清炎性因子及免疫功能变化,为AL的临床诊治提供参考。方法选取2014年1月-2015年10月医院收治的AL患者100例,其中发生感染54例,发生DIC 23例,检测C-反应蛋白(CRP)、D-二聚体(D-D)、白细胞介素-17(IL-17)、血清免疫球蛋白IgA、IgG、IgM水平。结果感染患者CRP、D-D为(64.02±11.54)mg/L、(0.68±0.25)μg/L,高于未感染患者;IL-17为(243.94±110.71)pg/ml低于未感染患者;发生DIC患者CRP、D-D为(97.71±19.40)mg/L、(3.72±1.32)μg/L高于未发生DIC患者;IL-17(178.14±115.32)pg/ml低于未发生DIC患者,差异均有统计学意义(P<0.05);感染患者IgA、IgG、IgM低于未感染患者,发生DIC患者IgA、IgG、IgM高于未发生DIC患者,差异均有统计学意义(P<0.05)。结论 AL感染及DIC患者可表现为血清CRP、D-D的升高,IL-17及免疫功能的下降。

OBJECTIVE To explore the changes of serum inflammatory factors and immune function of acute leukemia（AL）patients with infections or disseminated intravascular coagulation（DIC）so as to provide guidance for clinical diagnosis and treatment of AL.METHODS A total of 100 AL patients who were treated in hospitals from Jan 2014 to Oct 2015,including 54 patients with infections and 23 patients with DIC,were enrolled in the study.The levels of C-reactive protein（CRP）,D-Dimer（D-D）,interleukin-17（IL-17）,and serum immunoglobulins IgA,IgG,and IgM were detected.RESULTS The levels of CRP and D-D of the patients with infection were respectively（64.02±11.54）mg/L and（0.68±0.25）μg/L,higher than those of the patients without infections;the level of IL-17 of the patients with infection was（243.94±110.71）pg/ml,lower than that of the patients without infections.The levels of CRP and D-D of the patients with DIC were respectively（97.71±19.40）mg/L and（3.72±1.32）μg/L,higher than those of the patients without DIC;the level of IL-17 of the patients with DIC was（178.14±115.32）pg/ml,lower than that of the patients without DIC（P〈0.05）.The levels of IgA,IgG,and IgM of the patients with infection were lower than those of the patients without infections;the levels of IgA,IgG,and IgM of the patients with DIC were higher than those of the patients without DIC（P〈0.05）.CONCLUSION The AL patients with infections or DIC may present with the elevated levels of serum CRP and D-D,with the IL-17 and immune function declined.