成人继发性噬血细胞综合征的临床特征及预后分析  

Clinical features and prognosis of adult secondary hemophagocytic syndrome

作　　者：曹富娇 郭洁[1] 姜中兴[1] CAO Fujiao;GUO Jie;JIANG Zhongxing(Department of Hematology,the First Affiliated Hospital of Zhengzhou University,Zheng-zhou,450052,China)

机构地区：[1]郑州大学第一附属医院血液科,郑州450052

出　　处：《临床血液学杂志》2022年第9期668-673,共6页Journal of Clinical Hematology

摘　　要：目的:研究成人继发性噬血细胞综合征(HLH)患者的临床特征及预后相关因素。方法:回顾性分析2019年9月—2021年2月就诊于我院血液科的95例初诊继发性HLH患者的临床资料,分析其临床特征、治疗及预后因素。结果:95例患者的中位年龄51(19~79)岁;最常见病因为淋巴瘤,共34例(35.8%)。95例患者中64例(67.4%)死亡,中位生存时间72d。Cox单因素分析表明,成人继发性HLH的预后受性别、中性粒细胞水平、血小板计数、肌酐、尿素氮、活化部分凝血活酶时间等因素影响(P<0.05)。多因素Cox回归分析结果发现,中性粒细胞<1.0×10^(9)/L、活化部分凝血活酶时间>50s、尿素氮升高是成人继发性HLH的独立预后影响因素(P<0.05)。结论:成人继发性HLH的预后受多方面因素影响,中性粒细胞<1.0×10^(9)/L、活化部分凝血活酶时间>50s、尿素氮升高是患者死亡的独立危险因素。Objective:To explore the clinical features and prognostic factors of adult patients with secondary hemophagocytic syndrome(HLH).Methods:The clinical data of 95newly diagnosed patients with secondary HLH who were hospitalized from September 2019to February 2021were retrospectively analyzed,and clinical features,survival,and prognostic factors of patients were analyzed.Results:The median age of 95patients was 51(19-79)years old.The most common cause was lymphoma,with 34cases(35.8%).Of the 95patients,64cases(67.4%)died and the median survival time was 72days.Cox univariate analysis showed that sex,neutrophil lev-el,platelet count,creatinine,urea nitrogen,and activated partial thromboplastin time were related to the progno-sis of secondary HLH in adults(P<0.05).Multivariate Cox regression analysis showed that neutrophil<1.0×10^(9)/L,activated partial thromboplastin time>50s,and elevated urea nitrogen were independent prognostic fac-tors for secondary HLH in adults(P<0.05).Conclusion:The prognosis of adult secondary HLH is affected by many factors,neutrophil<1.0×10^(9) L,activated partial thromboplastin time>50sand elevated urea nitrogen are independent risk factors of death.

关 键 词：成人 噬血细胞综合征 临床特征 预后分析 

分 类 号：R551[医药卫生—血液循环系统疾病]