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目的 :研究中性粒细胞缺乏伴发热患者血浆中 IL - 6浓度和 C反应蛋白之间的关系 ,探讨 IL - 6在预测感染方面的作用。方法 :对 32例接受化疗的急性白血病患者的 5 0例次发热 ,采用 EL ISA法检测患者血浆 IL - 6浓度。结果 :有感染证据的病例 IL - 6水平均有不同程度的增高 ,且峰值较 C反应蛋白峰值提前 1d～ 3 d;在发热首日 ,革兰氏阴性菌血症患者 IL - 6水平 (中位数 195 2 ng/ L ,范围 10 5 3 ng/ L～ 2 0 794ng/ L )较革兰氏阳性菌血症患者 IL - 6水平 (中位数 2 83 ng/ L ,范围 91ng/ L～ 1496 ng/ L )显著增高 (P<0 .0 0 1)。不明原因发热患者 IL - 6水平也较肿瘤发热或治疗相关发热患者 IL - 6水平明显增高 (P<0 .0 0 5 )。结论 :IL - 6可作为早期预测感染的敏感指标 ,检测 IL - 6将有助于对急性白血病化疗后发热原因的判断。
Objective: To study the relationship between plasma IL - 6 concentration and C - reactive protein in patients with neutropenia and fever and to explore the role of IL - 6 in predicting infection. Methods: Fifty patients with fever in 32 patients with acute leukemia who underwent chemotherapy were enrolled in this study. Plasma EL - 6 concentration was measured by ELISA. Results: The levels of IL - 6 in patients with evidence of infection were increased to some extent and the peak value was 1 day to 3 days earlier than that of C - reactive protein. On the first day of fever, the level of IL - 6 in Gram negative bacteremia The median of 195 ng / L ranged from 105 ng / L to 2794 ng / L) was significantly higher than that of Gram - positive bacteremia patients (median 2 83 ng / L, range 91 ng / L ~ 1496 ng / L) was significantly higher (P <0.001). Patients with unexplained fever also had higher levels of IL - 6 than those with fever or treatment - related fever (P <0.05). Conclusion: IL - 6 can be used as a sensitive indicator of early predictive infection, and detection of IL - 6 may be helpful in judging the causes of fever after chemotherapy in patients with acute leukemia.