标题：大剂量异体输血对急性淋巴细胞白血病患儿血清 IL-2、IL-6、PGE2水平的影响

      作者：王欣然 1，郭辉 2    1.宝鸡市妇幼保健院儿三科，陕西 宝鸡 721000；2.宝鸡市中心医院输血科，陕西 宝鸡 721008

      卷次： 2021年32卷21期

      【摘要】 目的 探讨大剂量异体输血对急性淋巴细胞白血病患儿血清白细胞介素-2 (IL-2)、白细胞介素-6(IL-6)、前列腺素E2 (PGE2)水平的影响。方法 回顾性分析2018年8月至2019年8月宝鸡市妇幼保健院收治的80例急性淋巴细胞白血病患儿的临床资料，根据输血方式的不同分对照组和观察组，每组40例，对照组采用小剂量异体输血，观察组采用大剂量异体输血。输血后3个月比较两组患儿的临床疗效、血常规指标白细胞计数(WBC)、血红蛋白(HGB)、血小板计数(PLT)、中性粒细胞计数(NEU)以及血清 IL-2、IL-6、PGE2水平。结果 输血后3个月，观察组患儿的治疗总缓解率为95.0%，明显高于对照组的80.0%，差异具有统计学意义(P<0.05)；输血后3个月，观察组患儿的WBC、HGB、PLT、NEU分别为(4.10±0.69)×109/L、(115.73±16.24) g/L、(89.04±6.32)×109/L、(1.32±0.24)×109/L，对照组分别为(5.32±0.83)×109/L、(90.35±14.5) g/L、(75.89±5.20)×109/L、(0.96±0.21)×109/L，观察组患儿的WBC明显低于对照组，HGB、PLT、NEU明显高于对照组，差异均有统计学意义(P<0.05)；输血后 3个月，观察组患儿的血清IL-2、IL-6、PGE2分别为(108.18±10.36) pg/mL、(91.66±11.52) pg/mL、(510.13±32.94) pg/mL，对照组分别为(135.24±14.50) pg/mL、(103.36±15.85) pg/mL、(165.32±44.67) pg/mL，观察组患儿的 IL-2、IL-6明显低于对照组，PGE2明显高于对照组，差异均有统计学意义(P<0.05)。结论 大剂量异体输血能有效改善急性淋巴细胞白血病患儿血常规指标，降低血清 IL-2、IL-6，提高PGE2水平，值得临床推广。
      【关键词】 急性淋巴细胞白血病；异体输血；血常规；白细胞介素-2；白细胞介素-6；前列腺素E2；不良反应
      【中图分类号】 R729 【文献标识码】 A 【文章编号】 1003—6350（2021）21—2766—03

Effect of large-dose allogeneic blood transfusion on serum IL-2, IL-6, and PGE2 levels in children with acutelymphoblastic leukemia.
WANG Xin-ran 1, GUO Hui 2. 1. Third Department of Pediatrics, the Maternal and Child HealthCare Hospital of Baoji City, Baoji 721000, Shaanxi, CHINA; 2. Blood Transfusion Department, the Central Hospital of BaojiCity, Baoji 721008, Shaanxi, CHINA
【Abstract】 Objective To study effect of large-dose allogeneic blood transfusion on serum interleukin-2 (IL-2),interleukin-6 (IL-6), and prostaglandin E2 (PGE2) in children with acute lymphoblastic leukemia. Methods The clini-cal data of 80 children with acute lymphoblastic leukemia admitted to the Maternal and Child Health Care Hospital ofBaoji City from August 2018 to August 2019 were retrospectively analyzed. According to the different blood transfusionmethods, they were divided into control group and observation group, with 40 patients in each group. The control groupwas treated with small-dose allogeneic transfusion, and the observation group was treated with large-dose allogeneictransfusion. Three months after blood transfusion, the clinical efficacy, blood routine indicators such as white blood cellcount (WBC), hemoglobin (HGB), platelet count (PLT), neutrophil count (NEU), and serum IL-2, IL-6, PGE2 levels werecompared between the two groups. Results Three months after blood transfusion, the total remission rate of the observa-tion group was 95.0% , which was significantly higher than 80.0% of the control group (P<0.05). Three months afterblood transfusion, the WBC, HGB, PLT and NEU in the observation group were (4.10±0.69)×109/L, (115.73±16.24) g/L,(89.04±6.32)×109/L, (1.32±0.24)×109/L, while those of the control group were (5.32±0.83)×109/L, (90.35±14.5) g/L,(75.89±5.20)×109/L, (0.96±0.21)×109/L; the WBC of the observation group was significantly lower than that of the con-trol group, and HGB, PLT, and NEU were significantly higher than those in the control group, with statistically signifi-cant difference (P<0.05). Three months after blood transfusion, the serum levels of IL-2, IL-6, and PGE2 in the observa-tion group were (108.18±10.36) pg/mL, (91.66±11.52) pg/mL, (510.13±32.94) pg/mL, while those in the control groupwere (135.24±14.50) pg/mL, (103.36±15.85) pg/mL, (165.32±44.67) pg/mL; the IL-2 and IL-6 of the observation groupwere significantly lower than those of the control group, and PGE2 was significantly higher than that of the controlgroup, with statistically significant difference (P<0.05). Conclusion Large-dose allogeneic blood transfusion can effec-tively improve blood routine indicators in children with acute lymphoblastic leukemia, reduce serum IL-2, IL-6, and in-crease PGE2 levels, which is worthy of clinical promotion.
      【Key words】 Acute lymphoblastic leukemia; Allogeneic transfusion; Blood routine; Interleukin-2; Interleukin-6;Prostaglandin E2; Adverse reactions