血清铁蛋白升高在成人噬血细胞综合征诊断中的作用

The role of elevated serum ferritin in the diagnosis of adult hemophagocytic lymphohistiocytosis

目的：探究血清铁蛋白升高是否对成人噬血细胞综合征（HLH）的诊断具有重要作用。方法：对411例成人患者的临床信息进行回顾性研究。结果：血清铁蛋白高于5 000μg/L的患者中确诊HLH的比例为36.25%;血清铁蛋白高于10 000μg/L的患者中确诊HLH的比例为55.04%;血清铁蛋白高于15 000μg/L的患者中确诊HLH的比例为63.92%。在血清铁蛋白高于5 000μg/L同时出现发热、全血细胞减少、脾大和（或）肝功损害的成人患者中,确诊为HLH的比例为62.23%;在血清铁蛋白高于10 000μg/L同时出现发热、全血细胞减少、脾大和（或）肝功损害的成人患者中,诊断为HLH的比例为81.33%;在血清铁蛋白高于15 000μg/L同时出现发热、全血细胞减少、脾大和（或）肝功损害的成人患者中,诊断为HLH的比例为86.89%。按照血清铁蛋白水平分组,≥15 000μg/L组与5 000-10 000μg/L组、10 000-15 000μg/L组比较,HLH患者比例存在显著差异,≥15 000μg/L组中HLH患者的比例明显高于其他2组（P〈0.05）。结论：血清铁蛋白升高对成人HLH的诊断可能具有重要作用。

Objective：To explore whether or not elevated serum ferritin play an important role in adult hemophagocytic lymphohistiocytosis（HLH）diagnosis.Method：We collected the clinical information of 411 patients and conducted a retrospective study.Result：We found that 36.25% of adult patients with serum ferritin levels higher than 5 000μg/L were diagnosed with HLH;55.04% of adult patients with serum ferritin levels higher than10 000μg/L were diagnosed with HLH;63.92% of adult patients with serum ferritin levels higher than 15000μg/L were diagnosed with HLH.In patients with serum ferritin levels above 5000μg/L,who also exhibited fever,pancytopenia,splenomegaly,and/or liver damage,62.23% were diagnosed with HLH;in adult patients with serum ferritin levels above 10000μg/L who simultaneously had fever,pancytopenia,splenomegaly,and/or with liver damage,81.33% was diagnosed with HLH;in adult patients with serum ferritin levels above 15000μg/L who simultaneously had fever,pancytopenia,splenomegaly,and/or with liver damage,86.89% was diagnosed with HLH.According to the serum ferritin level to make groups into≥15000μg/L group,5000 to 10000μg/L group and 10000 to 15 000μg/L group,there was significant difference between the≥15 000μg/L group and the other two groups（P〈0.05）.Conclusion：Elevated serum ferritin levels may play an important role in the diagnosis of adult HLH.