Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Pediatr Blood Cancer. 2010 Jul 15;55(1):91-4. doi: 10.1002/pbc.22507.
Early markers for predicting the severity of neutropenic fever (NF) in patients with hemato-oncological patients have not yet been established. Reactive oxygen species are known to play an important role in the antimicrobial function of neutrophils. The aim of this study was to determine the serum levels of derivatives of reactive oxygen metabolites (d-ROMs) and the biological antioxidant potential (BAP) levels in these patients, and to investigate the associations between these levels and the severity of NF.
Twenty-seven pediatric hemato-oncological patients were enroled in this prospective study. Their median age was 10 years (range 1-19). Laboratory samples for C-reactive protein (CRP), d-ROMs, and BAP were collected at the onset of NF. The Free Radical Analytical System 4(R) was used to measure levels of d-ROMs and BAP.
A total 36 NF episodes were evaluated. Levels of d-ROMs in NF patients with systemic inflammatory response syndrome (SIRS, n = 7) were significantly lower than those in subjects without SIRS (n = 29; 197.6 vs. 314.1 U.CARR, P = 0.017). There were no statistically significant differences in CRP, BAP, WBC count, or neutrophil count at the onset. The peak levels of CRP were significantly higher in patients with SIRS than in those without SIRS (23.9 vs. 6.1 mg/dl, P = 0.0003).
Patients with low level of d-ROMs at the onset of NF should be observed stringently since they possibly have severe NF.
目前尚未确定能够预测血液肿瘤患者中性粒细胞减少性发热（NF）严重程度的早期标志物。活性氧在中性粒细胞的抗菌功能中起着重要作用。本研究旨在测定这些患者的活性氧代谢物衍生（d-ROMs）的血清水平和生物抗氧化潜力（BAP）水平，并探讨这些水平与 NF 严重程度之间的关系。
本前瞻性研究纳入了 27 名儿科血液肿瘤患者。其中位年龄为 10 岁（范围 1-19 岁）。在 NF 发病时采集 C 反应蛋白（CRP）、d-ROMs 和 BAP 的实验室样本。使用 Free Radical Analytical System 4（R）测定 d-ROMs 和 BAP 的水平。
共评估了 36 次 NF 发作。有全身炎症反应综合征（SIRS，n = 7）的 NF 患者的 d-ROMs 水平明显低于无 SIRS 的患者（n = 29；197.6 与 314.1 U.CARR，P = 0.017）。在发病时，CRP、BAP、白细胞计数和中性粒细胞计数均无统计学差异。SIRS 患者的 CRP 峰值水平明显高于无 SIRS 的患者（23.9 与 6.1 mg/dl，P = 0.0003）。
NF 发病时 d-ROMs 水平较低的患者应严密观察，因为他们可能患有严重的 NF。
