合并噬血细胞综合征对非霍奇金淋巴瘤患者的临床预后影响及影响因素分析

发布时间：2018-04-02 16:02

本文选题：非霍奇金淋巴瘤　切入点：噬血细胞综合征　出处：《中国实验血液学杂志》2017年04期

【摘要】：目的:研究合并噬血细胞综合征对非霍奇金淋巴瘤患者临床预后的影响并分析其影响因素。方法:选取本院90例非霍奇金淋巴瘤患者,其中未伴有噬血细胞综合征者为A组(61例),而伴有噬血细胞综合征者为B组(29例);通过Kaplan-Meier方法进行生存分析;应用Cox回归模型对相关影响因素进行单因素及多因素分析。结果:B组多因发热而发病,其中89.66%(26/29)患者骨髓样本中发现有噬血细胞;B组总胆红素、甘油三酯、血清铁蛋白、血清可溶性CD25、乳酸脱氢酶水平及EBV-DNA拷贝数明显高于A组(P0.05),且体能状态较差、分期较迟、病情较重,整体预后低于A组。伴有噬血细胞综合征、治疗后病情未充分改善及EBV感染是非霍奇金淋巴瘤患者预后较差的独立危险因素。结论:非霍奇金淋巴瘤患者伴有噬血细胞综合征会加重病情,对临床预后有较大影响,而伴有噬血细胞综合症患者,其治疗效果不佳,EBV感染是影响NHL预后的独立危险因素。
[Abstract]:Objective: to study the effect of hemophagocytic syndrome on the clinical prognosis of non-Hodgkin's lymphoma and analyze its influencing factors.Methods: ninety patients with non-Hodgkin 's lymphoma in our hospital were selected, among them 61 patients without hemophagocytic syndrome and 29 patients with hemophagocytic syndrome were selected as group A and B respectively.Cox regression model was used to analyze the related factors.Results in group B, fever was the most common cause. In the bone marrow samples of patients with hematophagocytosis, total bilirubin, triglyceride and serum ferritin were found in group B.The levels of serum soluble CD25, lactate dehydrogenase and EBV-DNA copy number were significantly higher than those in group A (P 0.05), and the physical condition was poor, the stage was late, the disease was serious, and the overall prognosis was lower than that in group A.Hemophagocytic syndrome and EBV infection were independent risk factors for poor prognosis in patients with non Hodgkin's lymphoma.Conclusion: Non-Hodgkin 's lymphoma patients with hemophagocytic syndrome may aggravate the condition and have a great influence on the clinical prognosis. However, in patients with hemophagocytic syndrome, the treatment effect of EBV infection is an independent risk factor affecting the prognosis of NHL.
【作者单位】：福建医科大学附属第一医院血液科;
【分类号】：R55;R733.1

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