儿童急性淋巴细胞白血病合并感染病原菌及mNAP、TLR9、NF-κB mRNA水平变化

Pathogenic bacteria and expression of mNAP, TLR9 and NF-κB mRNA in children with acute lymphoblastic leukemia combined with infection

    摘要
  • 摘要:
    目的 探究儿童急性淋巴细胞白血病合并感染病原菌及中性粒细胞膜碱性磷酸酶(mNAP)、Toll样受体9(TLR9)、核转录因子(NF)-κB信使核糖核酸(mRNA)的诊断价值。
    方法 选取2022年1月-2023年11月江西省儿童医院收治的152例急性淋巴细胞白血病患儿为研究对象，根据是否合并感染分为感染组78例和未感染组74例。统计感染组感染部位分布情况、病原菌分布；比较两组mNAP、TLR9、NF-κB mRNA水平；mNAP、TLR9、NF-κB mRNA水平联合检测对儿童急性淋巴细胞白血病合并感染的诊断价值。
    结果 78例急性淋巴细胞白血病合并感染患儿感染部位主要位于呼吸系统，口腔和胃肠道感染占比次之，且检出93株病原菌，革兰阴性菌(以大肠埃希菌为主)为其主要的致病菌，革兰阳性菌(以表皮葡萄球菌为主)占比次之；感染组mNAP、TLR9、NF-κB mRNA水平高于非感染组(P < 0.05)；与mNAP、TLR9、NF-κB mRNA水平单独检测的曲线下面积(AUC)值相比，联合检测诊断急性淋巴细胞白血病合并感染患儿的AUC值更高(P < 0.05)，且联合检测的敏感度、特异度为74.36%、91.89%。
    结论 急性淋巴细胞白血病合并感染患儿感染的主要部位和病原菌分别是呼吸系统、革兰阴性菌，其mNAP、TLR9、NF-κB mRNA表达异常，且三者联合检测可提高对感染的诊断价值。

     

    Abstract:
    OBJECTIVE To investigate the pathogenic bacteria and diagnostic values of alkaline phosphatase on the surface membrane of neutrophils (mNAP), toll-like receptor 9 (TLR9) and nuclear factor κB (NF-κB) mRNA in children with acute lymphoblastic leukemia combined with infection.
    METHODS A total of 152 children with acute lymphoblastic leukemia admitted to Jiangxi Children′s Hospital from Jan. 2022 to Nov. 2023 were selected as the research objects and divided into the infection group (n=78) and non-infection group (n=74). The distribution of infection sites and pathogenic bacteria in the infection group were analyzed. The mNAP, TLR9 and NF-κB mRNA levels were compared between the two groups. The diagnostic values of combined detection of the three indexes were analyzed.
    RESULTS The main infection sites of 78 cases of the infection group were the respiratory system, followed by oral cavity and gastrointestinal tract; ninety-three strains of pathogenic bacteria were detected and predominated by negative bacteria (mainly Escherichia coli), followed by gram-positive bacteria (mainly Staphylococcus epidermalis). mNAP, TLR9 and NF-κB mRNA levels were significantly higher in the infection group than those in the non-infection group (P < 0.05). Compared with mNAP, TLR9 mRNA and NF-κB mRNA alone, the area under the curve (AUC) value of the combined detection was higher in the diagnosis of acute lymphoblastic leukemia combined with infection (P < 0.05) with the sensitivity 74.36% and specificity 91.89%.
    CONCLUSIONS The main site and pathogenic bacteria in children with acute lymphoblastic leukemia complicated with infection are respiratory system and gram-negative bacteria, respectively. mNAP, TLR9 and NF-κB mRNA express abnormally, the combined detection of which can improve the diagnostic ability for children with acute lymphoblastic leukemia combined with infection.

     

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