纤维蛋白原和铁蛋白在噬血细胞综合征诊疗中的价值

Clinical significance of serum ferritin and fibrinogen in the diagnosis and evaluation of treatment response in hemophagocytic syndrome

目的 探讨血清铁蛋白（SF）和纤维蛋白原（FIB）联合检测在噬血细胞综合征（HPS）患者的诊断与治疗效果评价中的意义。方法 采用免疫比浊法检测血清铁蛋白,凝固法检测纤维蛋白原,检测40例2008年1月-2014年10月在广西肿瘤防治研究所治疗的HPS患者（HPS组）和30例正常对照者（对照组）血清铁蛋白和纤维蛋白原水平,将HPS组按治疗效果分为缓解组（n=23）和未缓解组（n=17）。结果 正常对照组（SF：221.4±96.3μg/L,FIB：2.945±0.641 g/L）与HPS组（SF：5163.6±1033.1μg/L,FIB：1.470±0.415 g/L）、HPS治疗缓解组（SF：910.3±326.3μg/L,FIB：2.442±0.463 g/L）与未缓解组（SF：8412.8±2229.3μg/L,FIB：0.968±0.254 g/L）,血清铁蛋白水平比较,后者明显高于前者,差异有高度统计学意义（P〈0.01）;而纤维蛋白原水平则后者明显低于前者,差异有高度统计学意义（P〈0.01）;联合检测与单项检测比较,敏感性、准确性、阴性预测值均有提高,差异有统计学意义（P〈0.05）。结论 血清铁蛋白和纤维蛋白原的联合检测有助于噬血细胞综合征的诊断和治疗效果的评价。

Objective To investigate the clinical significance of serum ferritin and fibrinogen in the diagnosis and evaluation of treatment response in hemophagocytic syndrome. Methods Serum ferritin（with immunoturbidimetry） and fibrinogen（with clauss） were detected in 40 patients with HPS（HPS group） from January 2008 to October 2014 in Guangxi Cancer Institute,30 healthy people in normal group（control group） were established as control,and the HPS group was divided into remission group（n=23） and non-remission group（n=17） according to the treatment effects. Results The levels of serum ferritin in HPS group [SF：（5163.6±1033.1） μg/L] were significantly higher than in control group [SF：（221.4±96.3） μg/L],and the differences were statistical significance（P 〈0.01）; remission group[SF：（910.3±326.3） μg/L] were significantly lower than non-remission group [SF：（8412.8±2229.3） μg/L],and the differences were statistical significance（P〈 0.01）. The levels of fibrinogen in HPS group[FIB：（1.470±0.415） g/L] were significantly lower than control group [FIB：（2.945±0.641） g/L],and the differences were statistical significance（P 〈0.01）,and non-remission group [FIB：（0.968±0.254） g/L] were significantly lower than remission group[FIB：（2.442±0.463） g/L],and the differences were statistical significance（P 〈0.01）;the sensibility,veracity,negative predictive value of combined detection were higher than the single test,and the differences were statistical significance（P 〈0.05）. Conclusion Detection of serum ferritin and fibrinogen will be helpful in the diagnosis and evaluation of the effiancy of treatment in patients with hemophagocytic syndrome.