儿童噬血细胞性淋巴组织细胞增生症预后危险因素分析

发布时间：2018-06-03 17:31

本文选题：噬血细胞性淋巴组织细胞增生症 + 预后　；参考：《广西医科大学》2012年硕士论文

【摘要】：目的：通过总结儿童噬血细胞性淋巴组织细胞增生症的临床特征，了解其长期生存率，并探索影响噬血细胞性淋巴组织细胞增生症患儿预后的危险因素。方法：收集2005年1月至2010年12月在广西医科大学一附院儿科确诊为噬血细胞性淋巴组织细胞增生症的63例病例资料，，采用回顾性分析，总结临床特征，利用SPSS16.0软件进行数据统计，其中使用Kaplan-Meier法绘制生存曲线，采用COX模型对相关因素进行单因素分析，筛选出有意义的因素进行多因素分析，P0.05有统计学意义。结果：1.本组患儿年龄多在1至3岁之间，男女比例为2:1；临床表现以发热，肝脾肿大常见，常见的实验室表现为乳酸脱氢酶升高、铁蛋白升高、骨髓噬血现象、血细胞减少及肝功能损害等。2.患儿的3年及5年生存率均为62.9%；而在确诊后4个月生存率降至73.2%。3.影响儿童噬血细胞性淋巴组织细胞增生症预后单因素分析中，具有统计学意义的因素只有治疗2至3周后血小板恢复情况（P=0.002）；在使用依托泊苷治疗的患儿中，治疗一天后体温恢复正常对预后的影响具有统计学意义（P=0.016）。结论：1. HLH患儿在确诊后的前4个月生存率下降明显。2.治疗2至3周后血小板下降或无回升趋势者，以及使用依托泊苷一天后体温不能恢复正常者，预后较差，生存率较低。
[Abstract]:Objective: to summarize the clinical features of hemophagocytic lymphohistiocytosis in children, to understand the long-term survival rate and to explore the risk factors affecting the prognosis of children with hemophagocytic lymphohistiocytosis. Methods: from January 2005 to December 2010, 63 cases of hemophagocytic lymphohistiocytosis diagnosed in pediatrics of the affiliated Hospital of Guangxi Medical University were collected, and the clinical features were summarized by retrospective analysis. SPSS16.0 software was used for data statistics, among which Kaplan-Meier method was used to draw survival curve, COX model was used to carry out single factor analysis, and significant factors were screened out for multivariate analysis (P0.05). The result is 1: 1. Most of the children were between 1 and 3 years old, and the ratio of male and female was 2: 1.The clinical manifestations were fever, hepatosplenomegaly. The common laboratory manifestations were increased lactate dehydrogenase, elevated ferritin, and hemophagocytosis of bone marrow. Blood cell decrease and liver function damage. The 3-year and 5-year survival rates were 62.9% and 73.2%, respectively. In univariate analysis of prognosis of hemophagocytic lymphohistiocytosis in children, the only statistically significant factors were platelet recovery after 2 to 3 weeks of treatment. One day after treatment, the effect of normal body temperature on prognosis was statistically significant. Conclusion 1. The survival rate in the first 4 months after diagnosis of HLH patients decreased significantly. 2. 2. The prognosis was poor and the survival rate was lower in patients with platelet decline or no upward trend after 2 to 3 weeks of treatment, and those whose body temperature could not return to normal after one day of etoposide treatment.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.5

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