IL-6、IL-10、hs-CRP及PCT在儿童急性淋巴细胞白血病合并感染中的诊断价值

Diagnostic Value of Interleukin-6,Interleukin-10,High-sensitivity C-reactive Protein and Procalcitonin in Children with Acute Lymphoblastic Leukemia Complicated by Infection

目的 探讨外周血白介素-6(IL-6)、白介素-10(IL-10)、超敏C反应蛋白(hs-CRP)和降钙素原(PCT)在儿童急性淋巴细胞白血病(ALL)合并感染中的诊断意义。方法 选取2018年1月至2019年12月昆明市儿童医院收治的141例ALL患儿为研究对象,根据是否合并感染分为未感染组49例,感染组92例,其中轻度感染组69例,重度感染者23例。对2组研究对象外周血中IL-6、IL-10、hs-CRP及PCT进行比较,分析4个感染指标在ALL患儿合并感染中的诊断效能。结果 感染组患儿外周血4个感染指标水平均高于非感染组(P <0.05),与轻度感染组相比,重度感染组外周血中4个感染指标水平升高更明显。外周血中IL-6、PCT、IL-10、hs-CRP及四者联合诊断ALL合并感染的ROC曲线下面积(AUC)分别为0.887、0.781、0.765、0.681及0.923。结论 IL-6、IL-10、hs-CRP、PCT在ALL合并感染的诊断中有一定的诊断意义,其中IL-6的诊断效能最高,四者联合使用可以提高ALL合并感染的诊断价值。

Objective To explore peripheral blood interleukin-6(IL-6),interleukin-10(IL-10)hypersensitive C-reactive protein(hs-CRP)and procalcitonin(PCT)in children with acute lymphoblastic leukemia(ALL)co-infection.Methods A total of 141 children with ALL who were admitted to Kunming Children’s Hospital from January 2018 to December 2019 were selected as the research objects.49 cases were entered into the uninfected group and 92 cases into the infection group(in which 69 cases with the mild infection and 23 cases with the severe infection)according to whether they were co-infected or not.The peripheral blood IL-6,IL-10,hs-CRP and PCT of the two groups were compared,and the diagnostic efficacy of the four infection indicators in ALL children with co-infection was analyzed.Results The four infection indexes in the peripheral blood of the infected group were higher than those in the non-infected group(P<0.05).Compared with the mild infection group,the four infection indexes in the severe infection group increased significantly.The area under the ROC curve(AUC)of IL-6,PCT,IL-10,hs-CRP and their combination in the diagnosis of ALL co-infection in peripheral blood were 0.887,0.781,0.765,0.681 and 0.923,respectively.Conclusion IL-6,IL-10,hs-CRP and PCT have the certain diagnostic significance in the diagnosis of ALL co-infection.Among them,IL-6 has the highest diagnostic efficiency.The combination of the four can improve the diagnostic value of ALL co-infection.