30例淋巴瘤相关噬血细胞综合征危险因素分析

Analysis Predict Factors of Lymphoma Associated Hemophagocytic Syndrome

目的分析近5年淋巴瘤相关噬血细胞综合征患者临床相关资料,寻找早期预测淋巴瘤相关噬血细胞综合征发生因素。方法分析近5年30例LAHS患者与同期30例对照患者临床临床相关资料年龄、Ann-Arbor分期、IPI指数、发热、肝脾肿大、外周血白细胞数、血小板数目、血红蛋白浓度、CRP、LDH、β2-MG(放射免疫法)、总胆红素、铁蛋白(放射免疫法)、IL-10(酶联免疫吸附法)、TNF-α(酶联免疫吸附法)、miR-133、EBV病毒载量(实时定量PCR法)等进行分析。结果 (1)患者分期、IPI评分、病理类型与LAHS发生无相关性,但患者肝脾肿大及无法解释的高热与LAHS发生相关。(2)高水平炎征因子预示患者发生LAHS可能性高于无相关表现者。(3)患者初诊时存在EBV感染更易发生。(4)外周血中高水平miR-133预测发生LAHS可能性明显升高。结论研究表明早期预测患者发生LAHS是可行的,患者早期出现部分临床表现可能与LAHS发生相关:起病时不明原因高热、肝脾明显肿大,高水平炎症因子、EBV感染及外周血中高水平miR-133预测均有预测意义。

Objective Analysis the clinical data of patients with LAHS in our center,to find out factors that can predict happen LAHS. Methods We retrospectively analysis the clinical data each group 30 cases who with LAHS and without LAHS. We used factors： the age,Ann-Arbor stage,IPI index,fever,hepatosplenomegaly,peripheral white blood cell count,platelet count,hemoglobin concentration,TNF-α,TNF-α,IL-10,total bilirubin,the copy of EBV viral and miR-133. Results（1）The IPI score,pathologic type has no relationship with LAHS,but patients who with hepatosplenomegaly and Fever of Unknown Origin were associated with LAHS.（2）The levels of inflammatory factors in patients indicates that the possibility of higher LAHS than those who without high level of inflammatory factors.（3）Patients who with EBV infection are more likely to occur to LAHS.（4）The level of miR-133 in peripheral blood predicts the possibility of LAHS. Conclusions Our research results show some of the clinical data may predict factors as occur of LAHS. Fever of Unknown Origin,hepatosplenomegaly,high levels of inflammatory factors,EBV infection and high level of miR-133 may predict factors for LAHS.