Aittoniemi J, Miettinen A, Laine S, Sinisalo M, Laippala P, Vilpo L, Vilpo J
Department of Clinical Microbiology, Tampere University Hospital, Finland.
Leuk Lymphoma. 1999 Jul;34(3-4):381-5. doi: 10.3109/10428199909050963.
We investigated the influence of plasma concentrations of immunoglobulin G (IgG), IgA, IgM, IgG subclasses and mannan-binding lectin (MBL) on susceptibility to infection in patients with chronic lymphocytic leukemia (CLL). Of 28 patients with CLL, increased susceptibility to infection was recorded in nine. Four of them (44%) had hypogammaglobulinemia as opposed to only one (5%) of the 19 patients without increased susceptibility to infection (OR 14.4; 95% CI, 1.6-130). When the effect of IgG subclasses contributing to hypogammaglobulinemia was studied, only the decreased concentrations of IgG4 and IgG2 were associated with increased susceptibility to infection. They, in turn, were intercorrelated and also highly correlated with the concentration of IgA. In fact, when these parameters were studied by a multivariable model, only the decreased concentration of IgA was shown as an independent risk factor for infection (P = 0.03). The mean concentration of MBL was significantly higher in patients with infections than in those without (6.54 mg/l and 2.75 mg/l, respectively; P = 0.001). The monitoring of its concentrations might be useful in the follow-up of infectious morbidity in CLL.
我们研究了慢性淋巴细胞白血病（CLL）患者血浆中免疫球蛋白G（IgG）、IgA、IgM、IgG亚类和甘露糖结合凝集素（MBL）的浓度对感染易感性的影响。在28例CLL患者中，有9例记录到感染易感性增加。其中4例（44%）有低丙种球蛋白血症，而在19例感染易感性未增加的患者中只有1例（5%）有低丙种球蛋白血症（比值比14.4；95%可信区间，1.6 - 130）。在研究导致低丙种球蛋白血症的IgG亚类的作用时，只有IgG4和IgG2浓度降低与感染易感性增加相关。它们彼此相互关联，并且与IgA浓度也高度相关。事实上，当通过多变量模型研究这些参数时，只有IgA浓度降低被显示为感染的独立危险因素（P = 0.03）。感染患者的MBL平均浓度显著高于未感染患者（分别为6.54 mg/l和2.75 mg/l；P = 0.001）。监测其浓度可能对CLL患者感染发病率的随访有用。
