急性白血病化疗后继发感染性休克患者血清炎性介质变化研究

Changes of serum inflammatory mediators in secondary septic shock after chemotherapy for acute leukemia

目的 观察与分析急性白血病化疗后继发感染性休克患者血清炎性介质变化状态。方法 选取56例急性白血病患者化疗后继发感染性休克患者为A组,56例急性白血病患者化疗后未继发感染性休克患者为B组,56例同龄健康者为C组,然后检测与比较3组血清炎性介质水平,同时将A组中不同休克严重程度患者的血清指标进行比较,并比较A组与B组不同分类（淋巴细胞与非淋巴细胞白血病）患者的检测结果。结果 血清炎症介质水平,如肿瘤坏死因子（TNF-α）、白细胞介素（IL-4）、IL-6、IL-10及其他炎性介质,如前列腺素E2（PGE2）、可溶性细胞间粘附分子（sICAM-1）、血管细胞间粘附分子（sVCAM-1）及sCD44,A组〉B组〉C组,重度患者〉中度患者〉轻度患者（P均〈0.05）。A组中不同分类患者的上述血清细胞因子及其他血清炎性介质水平均高于B组,且A组与B组中淋巴细胞白血病患者的检测结果均高于非淋巴细胞白血病患者（P均〈0.05）。结论 急性白血病化疗后继发感染性休克患者血清炎性介质呈现高表达状态,且休克严重程度及白血病分类对其表达均有影响。

Objective To observe and analyze the change state of serum inflammatory mediators of patients with secondary septic shock after chemotherapy for acute leukemia .Methods 56 patients with secondary septic shock after chemotherapy for acute leukemiawere were selected as the group A,56 patients without secondary septic shock after chemotherapy for acute leukemia were selected as the group B ,56 healthy persons of the same age were selected as the group C,then the serum inflammatory mediators levels of three groups were detected and compared,and the serum indexes of group A with different severity degree of shock were compared, then the detection results of group A and group B with different types （ lymphocytic leukemia and nonlymphocytic leukemia）were compared.Results The serum inflammatory mediators levels, including TNF-α, IL-4, IL-6, IL-10 and other inflammatory factors, including PGE2 , sICAM-1, sVCAM-1 and sCD44, there were group A 〉group B 〉group C, severe shock 〉moderate shock〉mild shock （ all P〈0.05 ） .The above serum inflammatory mediators and other inflammatory factors levels of different types in group A were higher than those in group B, and the above mediators in lymphocytic leukemia of group A and group B were higher than those in nonlymphocytic leukemia （all P〈0.05）.Conclusion The serum inflammatory mediators of patients with secondary septic shock after chemotherapy for acute leukemia show higher expression state,and the influence of shock degree and leukemia types for the expression are great.