68例成人噬血细胞综合征患者临床特征和预后分析  

Analysis on clinical features and prognostic factors in 68 adult hemophagocytic syndrome

作　　者：张荣耀 沈艳群 郭毅刚 李章志 张露璐 ZHANG Rongyao;SHEN Yanqun;GUO Yigang;LI Zhangzhi;ZHANG Lulu(Department of Hematology,Taihe Hospital of Shiyan,Affiliated Hospital of Hubei University of Medicine,Shiyan 442000,Hubei,China)

机构地区：[1]十堰市太和医院湖北医药学院附属医院血液内科,湖北十堰4420001

出　　处：《中国现代医生》2025年第12期61-64,共4页China Modern Doctor

摘　　要：目的研究成人噬血细胞综合征(hemophagocytic syndrome,HPS)患者的临床特征及预后。方法回顾性分析2018年12月至2023年12月就诊于十堰市太和医院血液内科68例初诊HPS患者的临床资料,分析其临床特征、治疗及预后。结果68例患者中位发病年龄49(17~75)岁,最常见的病因是感染,共40例(58.82%),最常见的临床表现是发热,共63例(92.6%)。68例患者中12例(17.65%)死亡,中位生存时间32个月。Cox单因素分析发现成人HPS的预后受血清铁蛋白、EB病毒(epstein-barrvirus,EBV)感染、血小板计数(<20×10^(9)/L)、年龄>60岁,活化部分凝血活酶时间>60s等因素影响(P<0.05);多因素Cox分析发现EBV感染、血小板计数(<20×10^(9)/L)是成人HPS的独立预后影响因素(P<0.05)。结论成人HPS临床表现不典型,预后受多种因素影响,EBV感染、血小板计数(<20×10^(9)/L)是患者死亡的独立危险因素。Objective To explore the clinical features and prognostic factors of adult hemophagocytic syndrome(HPS).Methods The clinical data of 68 newly diagnosed patients with HPS who were hospitalized from December 2018 to December 2023 were retrospectively analyzed,and clinical features,treatment and prognostic factors of patients were analyzed.Results The median age of 68 patients was 49(17-75)years old,the most common cause was infection,40 cases(58.82%),and the most common clinical manifestation was fever,63 cases(92.6%).Of the 68 patients,12(17.65%)patients died and the median survival time was 32 months.Cox univariate analysis showed that the prognosis of adult HPS was affected by SF,epstein-barr virus(EBV)infection,platelet count(<20×10^(9)/L),age over 60 years old,activated partial thromboplastin over 60s and other factors(P<0.05).Multivariate Cox analysis showed that EBV infection and platelet count(<20×10^(9)/L)were independent prognostic factors of adult HPS(P<0.05).Conclusion The clinical manifestations of adult HPS are not typical,and the prognosis of adult HPS is affected by many factors.EBV infection and platelet count(<20×10^(9)/L)are independent risk factors for death.

关 键 词：噬血细胞综合征 临床特征 预后 

分 类 号：R593[医药卫生—内科学]