急性髓系白血病并感染病人血清CD64、IL-6、PDW水平与病原菌分布特征、感染预后的关联性

阮敏; 黄震琪; 吴炜; 梁莉; 曾庆曙

doi:10.13898/j.cnki.issn.1000-2200.2022.03.017

急性髓系白血病并感染病人血清CD64、IL-6、PDW水平与病原菌分布特征、感染预后的关联性

Correlation between serum levels of CD64, IL-6, PDW and distribution characteristics of pathogenic bacteria and infection prognosis in patients with acute myeloid leukemia complicated with infection

摘要

摘要:
目的观察急性髓系白血病并感染病人血清CD64、白细胞介素-6(IL-6)、血小板分布宽度(PDW)水平与病原菌分布特征、感染预后的关联性。
方法选取急性髓系白血病并感染病人90例为研究组，同期未合并感染急性髓系白血病病人90例为对照组。统计2组血清CD64、IL-6、PDW水平，研究组病原菌分布特征、不同感染类型、感染预后病人血清各指标水平，探讨急性髓系白血病并感染病人感染预后死亡的影响因素，分析血清各指标对急性髓系白血病并感染病人感染预后死亡的预测价值。
结果研究组血清CD64、IL-6、PDW水平均明显高于对照组(P < 0.01)；研究组90例病人分离出病原菌118株，主要菌种为革兰阴性菌，共78株(66.10%)，其次为革兰阳性菌30株(25.42%)、真菌10株(8.47%)；研究组革兰阴性菌感染病人血清CD64、IL-6、PDW水平高于革兰阳性菌、真菌感染病人，革兰阳性菌感染病人血清各指标水平高于真菌感染病人，死亡病人血清各指标水平高于生存病人(P < 0.05)；logistic回归分析发现，血清CD64、IL-6、PDW均为急性髓系白血病并感染病人感染预后死亡的重要危险因素(P < 0.01)；ROC曲线显示，选取血清CD64、IL-6、PDW联合预测急性髓系白血病并感染病人感染预后死亡的特异度为82.43%，敏感度为81.25%。
结论急性髓系白血病并感染病人血清CD64、白细胞介素-6、PDW水平显著增高，且表达与病人病原菌分布特征、感染预后具有密切关系。

Abstract:
ObjectiveTo observe the correlation between the serum levels of CD64, interleukin-6(IL-6), platelet distribution width(PDW) and the distribution characteristics of pathogenic bacteria and infection prognosis in patients with acute myeloid leukemia complicated with infection.
MethodsNinety patients with acute myeloid leukemia complicated with infection were selected as the study group, and 90 patients with acute myeloid leukemia without infection were selected as the control group. The serum levels of CD64, IL-6 and PDW in the two groups, the distribution characteristics of pathogenic bacteria in the study group, and the serum levels of the above indicators in patients with different infection type and infection prognosis were analyzed. The influencing factors of infection prognosis and death in patients with acute myeloid leukemia complicated with infection was explored, and the predictive value of the above serum indicators for the infection prognosis and death in patients with acute myeloid leukemia and infection was analyzed.
ResultsThe serum levels of CD64, IL-6 and PDW in study group were higher than those in control group(P < 0.05). One hundred and eighteen strains of pathogenic bacteria were isolated from 90 patients in the study group, which were main Gram-negative bacteria, with a total of 78 strains(66.10%), followed by 30 strains(25.42%) of Gram-positive bacteria and 10 strains(8.47%) of fungi. In the study group, the serum levels of CD64, IL-6 and PDW in patients with Gram-negative bacteria infection were higher than those in patients with Gram-positive bacteria and fungi infection, the serum levels of the above indicators in patients with Gram-positive bacteria infection were higher than those in patients with fungi infection, and the serum levels of the above indicators in dead patients were higher than those in survival patients(P < 0.05). Logistic regression analysis showed that serum CD64, IL-6 and PDW were important risk factors for prognosis and death of patients with acute myeloid leukemia complicated with infection(P < 0.01). The ROC curve showed that the specificity and sensitivity of combination of serum CD64, IL-6 and PDW to predict the prognosis and death of patients with acute myeloid leukemia complicated with infection were 82.43% and 81.25%, respectively.
ConclusionsThe serum levels of CD64, IL-6 and PDW in patients with acute myeloid leukemia complicated with infection are significantly increased, and the expressions are closely related to the distribution characteristics of pathogenic bacteria and infection prognosis.

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