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摘要
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 haematologyeoncology 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.
- 出版日期2016-12
- 单位浙江大学
