血清铁蛋白在儿童噬血细胞综合征疗效评估中的价值

The value of serum ferritin in evaluating therapeutic effect of hemophagocytic syndrome in children

目的探讨血清铁蛋白(SF)在儿童噬血细胞综合征(HPS)疗效评估中的价值。方法回顾性分析2014年5月—2016年5月湖南省儿童医院重症监护室及血液内科收治的120例HPS患儿的临床资料,根据其转归将120例HPS患儿分为存活组(90例)和死亡组(30例),测定两组SF、纤维蛋白原(FIB)并进行比较。结果治疗前,存活组和死亡组SF、FIB均无明显差异[SF(μg/L):5 115.88±15.42、5 120.90±15.50,FIB(g/L):1.60±0.35、1.58±0.32,均P>0.05]。与治疗前比较,存活组治疗后SF明显降低(μg/L:909.87±20.32比5 115.88±15.42),FIB则明显升高(g/L:2.45±0.30比1.60±0.35);而死亡组变化则相反[SF(μg/L):8 410.88±20.20比5 120.90±15.50,FIB(g/L):0.88±0.27比1.58±0.32];治疗后,存活组SF明显低于死亡组(μg/L:909.87±20.32比8 410.88±20.20),FIB则明显高于死亡组(g/L:2.45±0.30比0.88±0.27),差异均有统计学意义(均P<0.05)。结论 SF可准确揭示HPS活动度,对评估临床治疗效果具有重要参考价值,值得在今后诊疗工作中推广使用。

Objective To estimate the value of serum ferritin（SF） in predicting the outcome of hemophagocytic syndrome（HPS） in children. Methods A retrospective analysis of the clinical data of 120 children with HPS admitted into Intensive Care Unit and Hematology Department of Hunan Children＇s Hospital from May 2014 to May 2016 was performed. Based on their different outcomes, they were divided into a survival group（90 cases） and a death group（30 cases）. The concentrations of serum SF and fibrinogen（FIB） in the two groups were measured and compared. Results There were no statistical significant level differences in serum SF and FIB between the two groups before treatment [SF（μg/L）： 5 115.88±15.42, 5 120.90±15.50, FIB（g/L）： 1.60±0.35, 1.58±0.32, all P〈0.05]. Compared with those before treatment, the level of SF was significantly lower（μg/L： 909.87±20.32 vs. 5 115.88±15.42）, while the level of FIB was obviously higher（g/L： 2.45±0.30 vs. 1.60±0.35） in the survival group after treatment; however,the SF and FIB level changes before and after treatment in the death group was exactly the opposite to those of the survival group [SF（μg/L）： 8 410.88±20.20 vs. 5 120.90±15.50, FIB（g/L）： 0.88±0.27 vs. 1.58±0.32]. After treatment, the level of SF in the survival group was significantly lower than that in the death group（μg/L： 909.87±20.32 vs. 8 410.88±20.20）, and the level of FIB was markedly higher than that in the death group（g/L： 2.45±0.30 vs. 0.88±0.27）, the differences being statistically significant（all P〈0.05）. Conclusion The level of serum SF can accurately reveal the activity of HPS, and has important reference value for evaluating the clinical therapeutic effect, thus the detection of serum SF in patients with HPS is worthwhile to be popularized and applied in the future.