IL-6预测多发性骨髓瘤患者化疗期间发生肺部感染的临床效能

The clinical value of IL-6 in predicting the incidence of pulmonary infections during chemotherapy period in patients with multiple myeloma

目的 探讨多发性骨髓瘤(MM)患者血清中IL-6表达与肺部感染的相关性。方法 纳入2021年1月—2022年8月就诊于新乡医学院第一附属医院血液内科的160例MM患者(MM组)和40例健康体检者(对照组)作为研究对象。根据MM患者化疗期间是否发生肺部感染分为感染组(65例)和未感染组(95例),并对肺部感染患者呼吸道分泌物进行细菌培养和鉴定。分析MM患者化疗期间发生肺部感染的危险因素,采用ROC曲线分析血清中IL-6表达水平预测MM患者化疗期间发生肺部感染的临床效能。结果 与对照组比较,MM组血清中IL-6表达水平升高[(76.45±6.59)mg/mL vs.(34.23±4.34)mg/mL,t=38.449,P<0.001]。感染组分泌物中共检测出78株病原菌,其中革兰阳性菌占52.56%(41/78),革兰阴性菌占43.59%(34/78),真菌占3.85%(3/78)。Durie-Salmon分期、国际标准分期、合并粒细胞缺乏症和IL-6均为MM患者化疗期间发生肺部感染的影响因素。血清中IL-6预测MM患者化疗期间发生肺部感染的AUC为0.924,诊断灵敏度和特异度分别为89.35%和93.22%。结论 MM患者血清中IL-6表达水平升高,化疗前血清中IL-6可作为预测MM患者化疗期间发生肺部感染的一项血清学标志物。

Objective This study aims to investigate the correlation between serum IL-6 expression levels and the occurrence of pulmonary infection in patients with multiple myeloma(MM).Methods This study enrolled a total of 160 MM patients diagnosed with multiple myeloma(MM group) and 40 healthy controls(Control group) from the Department of Hematology of the First Affiliated Hospital of Xinxiang Medical University between January 2021 and August 2022.Within the MM group,patients were divided into an infected group(n=65) and an uninfected group(n=95) according to the incidence of pulmonary infection during chemotherapy.Respiratory secretions were subjected to bacterial culture and identification.Risk factors of pulmonary infection in MM patients during chemotherapy period was analyzed.The clinical value of serum IL-6 expression levels in predicting the incidence of pulmonary infection during chemotherapy in MM patients was assessed using ROC curve analysis.Results Compared to the control group,the serum IL-6 expression level in the MM group significantly increased [(76.45±6.59) mg/mL vs.(34.23±4.34) mg/mL,t=38.449,P<0.001].Among the infected group,a total of 78 strains of pathogenic bacteria were detected,with gram-positive bacteria accounting for 52.56%(41/78),gram-negative bacteria accounting for 43.59%(34/78),and fungi accounting for 3.85%(3/78).Logistic regression analysis showed that Durie-Salmon stage,international staging system stage,agranulocytosis,and IL-6 were identified as influence factors for pulmonary infection during the chemotherapy period in MM patients.The area under the curve for serum IL-6 in predicting pulmonary infection during chemotherapy in MM patients was 0.924.The diagnostic sensitivity and specificity were 89.35% and 93.22%,respectively.Conclusion The serum expression level of IL-6 is significantly increased in MM patients.The pre-chemotherapy serum IL-6 expression level in MM patients can be used as a serological marker to predict the incidence of pulmonary infection during their chemotherapy period.