细胞因子模式及降钙素原用于预测儿科血液病/造血系统肿瘤患者感染的诊断效力比较

Comparison of the diagnostic power of cytokine patterns and procalcitonin for predicting infection among paediatric haematology/oncology patient
2017-02-27 07:42发表评论
作者:Xia, T, Xu, X, Zhao, N, Luo, Z, Tang, Y.
机构: 浙江大学医学院附属儿童医院血液肿瘤科
期刊: CLIN MICROBIOL INFEC2016年1月12期22卷

Objectives To evaluate the diagnostic power of the cytokine patterns and serum procalcitonin (PCT) level for predicting infection in paediatric haematology–oncology patients. Methods Retrospective study including hospitalized children with haematology–oncology disease was conducted and their serum T helper type 1/type 2 cytokines were measured by a flow cytometric method. According to clinical symptoms, imaging and microbiological findings, febrile episodes were divided into five diagnostic groups serving as reference standard; and also grouped according to disease severity. A control group consisted of afebrile children. Results A total of 3023 samples (2819 febrile episodes and 204 control samples) derived from 992 children (including 164 afebrile control patients) were obtained. Interleukin-6 (IL-6) and IL-10 levels as well as their positivity rates were significantly higher among children with bacteraemia than for the viral infection and control groups. Among children with bacteraemia, 92.8% (297/320) and 82.2% (263/320) had increased IL-6 and IL-10 levels that exceeded the upper limit of the normal range, respectively. The positivity rates of PCT and C-reactive protein were only 33.8% (108/320) and 73.1% (234/320), respectively, significantly lower than those of IL-6 and IL-10 (p <0.01). Based on the receiver operating characteristic curves, PCT exhibited poorer sensitivity in the diagnosis of severe infection compared with IL-6 and IL-10 (p <0.01). Specificity of IL-6 and IL-10 was significantly higher than that of PCT in the diagnosis of Gram-negative bacteraemia. Conclusion Cytokine patterns of IL-6 and IL-10 showed higher diagnostic accuracy than PCT for bacteraemia and severe infections among febrile children with haematology/oncology disease. © 2016 European Society of Clinical Microbiology and Infectious Diseases

通讯机构:Division of Haematology–Oncology, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China
学科代码:感染病学   关键词:细胞因子模式 降钙素 儿科 血液病 造血系统 肿瘤患者 ,中国作者重要发表 爱思唯尔医学网, Elseviermed
来源: Scopus
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