【摘要】 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。更多还原

【Abstract】 Objective:To conduct a retrospective analysis on clinical features of hemophagocytosis in bone marrow. Method:Fifty-five patients with hemophagocytosis in bone marrow confirmed by cytomorphological examination were studied.According to HPS2004 standard,they were divided into two groups(group A:hemophagocytic syndrome,group B:hemophagocytosis).We analyzed and summarized clinical characteristics,treatment and prognosis of 2 groups. Result:Among 55 patients,47 cases had fever(85.5%),32 cases had cytopenias involving at least two lineages of blood cells(59.2%),27 cases had splenomeglia(49.1%),29 cases had elevation of ferritin(52.7%),18 cases had elevation of ALT(32.7%),16 cases had lymphadenectasis(29%),15 cases had hepatomegaly(27.3%).There were 18 cases in Group A and 37 cases in group B.Etiology of these cases were mostly infection and lymphoma.By survival analysis,the survival rate of group B was higher than group A with statistical significance(t=5.707,P=0.017). Conclusion:Hemophagocytosis in bone marrow exists in variety of diseases,which may be the early presentation of hemophagocytic syndrome requiring comprehensive diagnosis by clinical features,laboratory examination and etc.We should pay high attention to this phenomenon by early detection and intervention in order to improve the curative rate and survival rate.更多还原