血清IL-6、IL-10水平与血液肿瘤患儿化疗期间感染程度的相关性

Correlation between serum levels of IL-6 and IL-10 and infection severity in children with hematologic tumors during chemotherapy

目的分析血清降钙素原(Procalcitonin,PCT)、白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-10(IL-10)水平与血液肿瘤患儿化疗期间感染严重程度的相关性。方法回顾性选取2017年1月-2019年1月海南省妇女儿童医学中心收治的血液肿瘤患儿117例,其中85例为感染组,32例为非感染组,比较两组患儿血清PCT、IL-6、IL-10水平;根据患儿感染严重程度,分为危重症感染组(n=19)、重症感染组(n=23)、局部感染组(n=43),分析上述因子水平与患儿化疗期间感染严重程度的关系。结果感染组患儿血清PCT、IL-6、IL-10水平均高于非感染组(P<0.05);PCT、IL-6及IL-10联合检测诊断血液肿瘤患儿是否感染,AUC为0.849(95%CI:0.761~0.928),诊断价值优于单项检测;不同感染严重程度患儿血清PCT、IL-6、IL-10水平比较,差异有统计学意义(P<0.05)。重症感染组血清PCT、IL-6、IL-10水平高于局部感染者(P<0.05);危重症感染组血清PCT、IL-6、IL-10水平高于局部感染、重症感染者(P<0.05);感染患者血清PCT、IL-6、IL-10水平分别与患儿感染严重程度呈正相关(P<0.05)。结论血液肿瘤患儿血清PCT、IL-6、IL-10水平与感染严重程度密切相关,感染严重患儿PCT、IL-6、IL-10水平升高更明显,临床监测上述因子水平可辅助血液肿瘤患儿感染的诊断及病情判断。

OBJECTIVE To analyze the correlation between serum procalcitonin(PCT),interleukin-6(IL-6)and interleukin-10(IL-10)levels and the infection severity in children with hematologic tumors during chemotherapy.METHODS A retrospective analysis was performed on 117 children with hematologic tumors who were admitted to Women and Children’s Medical Center in Hainan from Jan.2017 to Jan.2019.There were 85 cases with infection and 32 cases without infection.The levels of serum PCT,IL-6 and IL-10 were compared between the two groups.According to the infection severity,they were divided into the critical infection group(n=19),severe infection group(n=23)and local infection group(n=43).The relationship between the above factors and the infection severity of children during chemotherapy was analyzed.RESULTS The levels of serum PCT,IL-6 and IL-10 in the infection group were significantly higher than that in the non-infection group(P<0.05).The AUC of PCT combined with IL-6 and IL-10 for the diagnosis of infection in hematological tumor children was 0.849(95%CI:0.761~0.928),which was significantly higher than that of single detection(P<0.05).There were significant differences of serum PCT,IL-6 and IL-10 levels among children with different infection severity(P<0.05).The levels of serum PCT,IL-6 and IL-10 in the severe infection group were significantly higher than that in the local infection patients(P<0.05).The levels of serum PCT,IL-6 and IL-10 in the critical infection group were significantly higher than that in the local infection and severe infection groups(P<0.05).The levels of serum PCT,IL-6 and IL-10 in the infection patients were positively correlated with the severity of infection(P<0.05).CONCLUSION The levels of serum PCT,IL-6 and IL-10 in children with hematological tumors were closely related to the infection severity.The increase of PCT,IL-6 and IL-10 levels was more obvious in children with severe infection.Clinical monitoring on the above indexes was helpful to the diagnosis of infection in children with hematological tumors and disease determining.