Objective: To investigate the clinical value of expression level of interleukin-2 receptor (IL-2R) and interleukin-8 (IL-8) in the fever patients with hematological malignancies.
Methods: A total of 121 inpatients in the First Affiliated Hospital of Anhui Medical University from April 2018 to October 2019 were enrolled in this study. The patients were separated into infection group (61 cases) and non-infection group (60 cases). In the meantime, 40 healthy people without fever or infection in the hospital for physical examination were set as matched group. C-reactive protein (CRP), procalcitonin (PCT), and cytokines were detected in all the patients with fever after admission and infection control. While, blood samples were taken from healthy people during physical examination.
Results: The expression levels of IL-2R in infection group were higher than those in the control group (P<0.001), and the level of serum IL-2R in infection group was also higher than that in the non-infection group (P<0.05). Based on Spearman analysis, in patients with malignant hematologic disease, serum IL-2R level was positively correlated with CRP (r=0.557, P<0.001) and IL-8 (r=0.479, P<0.001), and IL-8 level was positively correlated with CRP (r=0.318, P<0.001). Compared with the non-infection group, the area under the curve (AUC) for the level of CRP, PCT, and IL-2R of the infection group was 0.714 (95%CI: 0.623-0.806), 0.765 (95%CI: 0.680-0.851), and 0.761 (95%CI: 0.686-0.836), the sensitivity was 0.705, 0.852, and 0.705, and the specificity was 0.717, 0.70, and 0.60, respectively. While, AUC of CRP+PCT, CRP+IL-2R, PCT+IL-2R, and CRP+PCT+IL-2R was 0.789 (95%CI: 0.712-0.866), 0.702 (95%CI: 0.623-0.782), 0.757 (95%CI: 0.677-0.838), and 0.789 (95%CI: 0.712-0.866), the sensitivity was 0.738, 0.934, 0.705, and 0.738, and the specificity was 0.840, 0.470, 0.810, and 0.840, respectively.
Conclusion: CRP, PCT, IL-2R, and IL-8 are useful parameters for diagnosis of the infectious fever in patients with hematological malignancies, which provides the basis of initial diagnosis and rational use of antibioties for clinician.
题目: 血清白介素-2受体、白介素-8表达水平对恶性血液病患者感染的临床价值.
目的: 探讨恶性血液病发热患者白介素-2受体（IL-2R）及白介素-8（IL-8）表达水平的临床意义.
方法: 选择2018年4月至2019年10月于安徽医科大学第一附属医院血液内科住院的121例恶性血液病发热患者，将患者分为感染组（61例）和非感染组（60例），同时选择无发热和感染的健康体检者为对照组（40例）。全部发热患者在入院后和感染控制后实时抽血进行C反应蛋白（CRP）、降钙素原（PCT）和细胞因子检测，健康体检者在体检时抽血检测.
结果: 感染组血清中IL-2R水平高于对照组，有极其显著统计学差异（P<0.001），感染组血清IL-2R水平高于非感染组，有统计学差异（P<0.05）。基于Spearman分析，恶性血液病患者血清中IL-2R水平与CRP（r=0.557，P<0.001）和IL-8（r=0.479，P<0.001）呈正相关，IL-8水平与CRP呈明显正相关（r=0.318，P<0.001）。与非感染组相比，感染组CRP、PCT和IL-2R的ROC曲线下面积（AUC）分别为0.714（95%CI：0.623-0.806）、0.765（95%CI：0.680-0.851）和0.761（95%CI：0.686-0.836），灵敏度分别为0.705、0.852和0.705，特异度分别为0.717、0.70和0.60；CRP+PCT、CRP+IL-2R、PCT+IL-2R和CRP+PCT+IL-2R联合诊断的AUC分别为0.789（95%CI：0.712-0.866）、0.702（95%CI：0.623-0.782）、0.757（95%CI：0.677-0.838）和0.789（95%CI：0.712-0.866），灵敏度分别为0.738、0.934、0.705和0.738，特异度分别为0.840、0.470、0.810和0.840.
结论: 联合检测CRP、PCT、IL-2R和IL-8有助于恶性血液病感染的诊断，为临床医师初期准确诊断及合理使用抗生素提供有力的依据.