Clinical Significance Of High Sensitive C-reactive Protein (hs-CRP)in Childhood With Acute Lymphoblastic Leukemia And Combined With Infection

Objective: To detect the level changes of high sensitive C-reactive protein (hs-CRP) which were collected through peripheral blood in children with acute lymphoblastic leukemia (ALL) without infection, combined with infection and infection control, to explore its clinical significance and provide a basis for clinical treatment.Methods:1 Cases and groups: 53 ALL children who needed regular chemotherapy after complete remission were collected in our hospital (blood group of pediatrics) from January 2009 to December 2009, including L1 17 cases, L2 36 cases and no L3 cases. A total of 320 chemotherapy treatments of 53 cases of ALL children were divided into infection group and non-infection group. The infection group was ALL children who combined with infections in any one time in the pre-chemotherapy, during chemotherapy and after chemotherapy, and there were a total of 138 times which included 55 times of respiratory infection, 43 times of gastrointestinal infection and 40 times of infection in other parts of the body. Only respiratory infection and gastrointestinal infection were used in this study. The efficacy was obvious after treatment with antibiotics in ALL children combined with infections. The non-infection group was the ALL children who had no infection in the pre-chemotherapy. We randomly selected 58 times for research. The control group was 40 cases of healthy children, whose age and sex were matched with the infection group and non-infection group.2 Specimens collection and handling: 15μl peripheral blood was collected for measuring hs-CRP in ALL children when they combined with infections (such as fever 1-2 days), infections control later (3-5 days after the temperature of body was normal) and without infections in the pre-chemotherapy after complete remission, and the data were recorded. 15μl peripheral blood also was collected for measuring hs-CRP in control group who had physical examination in our hospital pediatric outpatient, and the data were recorded.3 Statistical analysis: The test data obtained using SPSS 11.5 statistical software for analysis. The results were expressed with the Median (M) and Quartile Range (QR). Because the hs-CRP values were <0.5 mg/L or >200 mg/L in some ALL children and normal children, so we would use a unified assignment of 0.4 mg/L to replace the value of <0.5 mg/L and 201 mg/L to replace the value of >200 mg/L according to the need of statistics. The differences of hs-CRP among groups were analyzed by single-factor analysis of variance of comparisons in multiple means after transformed the variables, using P<0.05 as the significance level. Nonparametric test of two independent samples would be used to compare the two groups using the hs-CRP values after which were converted, using P<0.05 as the significance level.Results:1 The hs-CRP values of normal healthy children were <0.5 mg/L.2 The median and quartile range of hs-CRP in ALL children combined with infection were 43.200 (mg/L) and 56.975 (mg/L), and their values were 5.400 (mg/L) and 10.850 (mg/L) when the infections were completely controlled. In non-infection ALL children, the median and quartile range of hs-CRP were 0.400 (mg/L) and 0.000 (mg/L). The median and quartile range of hs-CRP were 0.400 (mg/L) and 0.000 (mg/L) in control group.3 The median and quartile range of hs-CRP in ALL children combined with gastrointestinal infection were 42.200 (mg/L) and 92.100 (mg/L), and their values were 5.600 (mg/L) and 10.100 (mg/L) when the infection was completely controlled. In ALL children combined with respiratory infection, the median and quartile range of hs-CRP were 52.700 (mg/L) and 49.200 (mg/L), and their values were 5.000 (mg/L) and 11.700 (mg/L) when the infection was completely controlled. 4 Comparisons between each group4.1 The expression level of hs-CRP in ALL children combined with infections was significantly higher than that of in after infection group, non-infection group and control group. The difference was significant (P<0.05).4.2 The expression level of hs-CRP in ALL children in after infection group were still higher than that of in non-infection group and control group. The difference was significant (P<0.05).4.3 The expression level of hs-CRP in non-infection group and control group were basically the same. There was no significant difference between them (P>0.05).5 Comparisons between the expression levels of hs-CRP in ALL children combined with respiratory infection and gastrointestinal infection showed no significant difference (P>0.05).Conclusions:1 The expression level of hs-CRP detected by collecting peripheral blood was high in ALL children with infections. Their level in ALL children with gastrointestinal infection and respiratory infection were basically the same expression. So it could be used as a simple, quick and sensitive index. The index had guiding significance for early diagnosis and treatment of ALL children with infections.2 The level of hs-CRP in ALL children decreased significantly after the infections were controlled. It suggested that the hs-CRP was a important detection parameter whether the infections were controlled in ALL children. At the same time, dynamic observation of hs-CRP changes would help to determine the incidence and control of the infections.3 There was no significant difference in the level of hs-CRP between normal children and non-infection ALL children.