摘要
目的:探讨急性髓系白血病(AML)合并感染患者血清免疫球蛋白、纤维蛋白原(FIB)、D-二聚体(D-D)表达变化及其与感染预后关系。方法:抽取2017年2月至2020年4月河南省南阳医学高等专科学校第一附属医院收治的68例AML合并感染患者为感染组,及同期68例未合并感染AML患者为未感染组。测定比较2组血清免疫球蛋白、FIB、D-D表达,应用Pearson相关性分析探讨AML合并感染患者血清各指标与常规感染指标水平关联性,并依据感染组患者感染预后情况分为死亡、生存患者,统计感染组不同感染预后患者血清各指标水平,并绘制受试者工作特征曲线(ROC曲线)观察血清各指标对AML合并感染患者感染预后死亡的预测意义。结果:感染组血清免疫球蛋白M(IgM)、免疫球蛋白G(IgG)和免疫球蛋白A(IgA)表达低于未感染组,FIB、D-D表达高于未感染组(P<0.05);AML合并感染患者血清IgM、IgG、IgA表达与血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)水平呈负相关,FIB、D-D表达与血清PCT、hs-CRP水平呈正相关(P<0.05);感染组中感染预后死亡患者血清IgM、IgG、IgA表达低于生存患者,FIB、D-D表达高于生存者(P<0.05);ROC曲线显示,血清IgM、IgG、IgA、FIB、D-D联合预测AML合并感染患者感染预后死亡曲线下面积(AUC)高于单一指标预测。结论:AML合并感染患者血清免疫球蛋白表达进一步降低,FIB、D-D表达升高,且与感染严重程度有关,在预测感染预后死亡方面具有较高应用价值。
Objective To investigate the changes of serum immunoglobulin,fibrinogen(FIB),D-dimer(D-D)expression in patients with acute myelocytic leukemia(AML)co-infection and its relationship with the prognosis of infection.Methods A total of 68 patients with AML co-infection in the First Affiliated Hospital of Nanyang Medical College from February 2017 to April 2020 were selected as the infection group,and 68 patients with non-infected AML in the same period were selected as the uninfected group.The expression of serum immunoglobulin,FIB and D-D in two groups was measured and compared.Using Pearson correlation analysis to explore the correlation between serum indexes of patients with AML co-infection and conventional infection indexes.According to the infection prognosis of patients in the infection group,they were divided into death and survival patients.The serum indicators of patients with different infection prognosis in the infection group were counted.The receiver operating characteristic(ROC)curve was drawn to observe the predictive significance of serum indicators on the prognosis of infection in patients with AML infection.Results The expression of serum immunoglobulin M(IgM),immunoglobulin G(IgG)and immunoglobulin A(IgA)in infected group was lower than that in uninfected group,and the expression of FIB and D-D was higher than that in uninfected group(P<0.05);serum IgM,IgG,IgA expression in patients with AML co-infection was significantly negatively correlated with serum procalcitonin(PCT)and hypersensitive-C reactive protein(hs-CRP)levels,and FIB,D-D expression was significantly positively correlated with serum PCT and hs-CRP levels(P<0.05);the serum IgM,IgG,IgA expression of patients with prognosis and death in the infection group was lower than that of survival patients,and the expression of FIB,D-D was higher than that of survival patients(P<0.05);The ROC curve showed that the combined area under the curve(AUC)of serum IgM,IgG,IgA,FIB,and D-D predicted the prognosis of death in patients with AML co-infection was higher than that predicted by a single indicator.Conclusions The expression of serum immunoglobulin in patients with AML co-infection is further reduced,the expression of FIB and D-D is increased,and it is related to the severity of infection.It has high application value in predicting the prognosis of infection and death.
作者
林晓媛
Lin Xiaoyuan(Second Ward of Hematology,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)
出处
《中国实用医刊》
2021年第12期38-41,共4页
Chinese Journal of Practical Medicine
