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目的:回顾性分析骨髓噬血细胞现象的临床特点。方法:收集行骨髓细胞学检查提示有噬血细胞现象的病例55例,根据HPS2004标准分为两组,即噬血细胞综合征组(HPS组)和噬血细胞增多症组(非HPS组),分析总结两组病例的临床特征、治疗及预后。结果:55例患者中发热47例(85.5%),2系以上血细胞减少32例(59.2%),脾大27例(49.1%),铁蛋白升高29例(52.7%),其他包括谷丙转氨酶升高18例(32.7%),淋巴结肿大16例(29%),肝大15例(27.3%)等。HPS组18例,非HPS组37例,两组的病因多为感染和淋巴瘤。通过生存分析发现,非HPS组的生存率高于HPS组,差异有统计学意义(P<0.05)。结论:骨髓噬血细胞现象存在于各种疾病中,应根据患者的临床特点、实验室检查等作出综合诊断。噬血细胞增多症是HPS的前期表现,应该引起临床医生的高度重视,及早发现及干预,从而提高患者的治愈率和生存率。
Objective: To retrospectively analyze the clinical features of bone marrow hemophagocytic phenomenon. Methods: Fifty-five cases of hemophagocytic cell lineage cytology were collected and divided into two groups according to HPS2004 standard: hemophagocytic syndrome group (HPS group) and hemophagocytosis group (non-HPS group) Clinical characteristics, treatment and prognosis of two groups of patients. Results: In the 55 patients, 47 cases (85.5%) had fever, 32 cases (59.2%) had cytopenia in 2 lines, 27 cases (49.1%) had splenomegaly, and 29 cases (52.7%) had ferritin increased. Elevated transaminase in 18 cases (32.7%), lymphadenopathy in 16 cases (29%), hepatomegaly in 15 cases (27.3%) and so on. HPS group 18 cases, non-HPS group 37 cases, the two groups were mostly etiological and lymphomas. Survival analysis showed that the survival rate of non-HPS group was higher than that of HPS group, the difference was statistically significant (P <0.05). Conclusion: Bone marrow hemophagocytic cells exist in a variety of diseases and should be diagnosed according to the clinical features of patients and laboratory tests. Hemophagocytosis is a pre-HPS performance, clinicians should cause great attention, early detection and intervention, thereby enhancing the patient’s cure rate and survival rate.