本文選題：噬血細胞性淋巴組織細胞增生癥 + 預后��； 參考：《廣西醫(yī)科大學》2012年碩士論文

【摘要】：目的：通過總結兒童噬血細胞性淋巴組織細胞增生癥的臨床特征，了解其長期生存率，并探索影響噬血細胞性淋巴組織細胞增生癥患兒預后的危險因素。 方法：收集2005年1月至2010年12月在廣西醫(yī)科大學一附院兒科確診為噬血細胞性淋巴組織細胞增生癥的63例病例資料，，采用回顧性分析，總結臨床特征，利用SPSS16.0軟件進行數據統(tǒng)計，其中使用Kaplan-Meier法繪制生存曲線，采用COX模型對相關因素進行單因素分析，篩選出有意義的因素進行多因素分析，P0.05有統(tǒng)計學意義。 結果：1.本組患兒年齡多在1至3歲之間，男女比例為2:1；臨床表現以發(fā)熱，肝脾腫大常見，常見的實驗室表現為乳酸脫氫酶升高、鐵蛋白升高、骨髓噬血現象、血細胞減少及肝功能損害等。2.患兒的3年及5年生存率均為62.9%；而在確診后4個月生存率降至73.2%。3.影響兒童噬血細胞性淋巴組織細胞增生癥預后單因素分析中，具有統(tǒng)計學意義的因素只有治療2至3周后血小板恢復情況（P=0.002）；在使用依托泊苷治療的患兒中，治療一天后體溫恢復正常對預后的影響具有統(tǒng)計學意義（P=0.016）。 結論：1. HLH患兒在確診后的前4個月生存率下降明顯。2.治療2至3周后血小板下降或無回升趨勢者，以及使用依托泊苷一天后體溫不能恢復正常者，預后較差，生存率較低。
[Abstract]:Objective: to summarize the clinical features of hemophagocytic lymphohistiocytosis in children, to understand the long-term survival rate and to explore the risk factors affecting the prognosis of children with hemophagocytic lymphohistiocytosis. Methods: from January 2005 to December 2010, 63 cases of hemophagocytic lymphohistiocytosis diagnosed in pediatrics of the affiliated Hospital of Guangxi Medical University were collected, and the clinical features were summarized by retrospective analysis. SPSS16.0 software was used for data statistics, among which Kaplan-Meier method was used to draw survival curve, COX model was used to carry out single factor analysis, and significant factors were screened out for multivariate analysis (P0.05). The result is 1: 1. Most of the children were between 1 and 3 years old, and the ratio of male and female was 2: 1.The clinical manifestations were fever, hepatosplenomegaly. The common laboratory manifestations were increased lactate dehydrogenase, elevated ferritin, and hemophagocytosis of bone marrow. Blood cell decrease and liver function damage. The 3-year and 5-year survival rates were 62.9% and 73.2%, respectively. In univariate analysis of prognosis of hemophagocytic lymphohistiocytosis in children, the only statistically significant factors were platelet recovery after 2 to 3 weeks of treatment. One day after treatment, the effect of normal body temperature on prognosis was statistically significant. Conclusion 1. The survival rate in the first 4 months after diagnosis of HLH patients decreased significantly. 2. 2. The prognosis was poor and the survival rate was lower in patients with platelet decline or no upward trend after 2 to 3 weeks of treatment, and those whose body temperature could not return to normal after one day of etoposide treatment.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R725.5

【參考文獻】

相關期刊論文 前6條

1 王冠玲;胡群;張柳清;劉愛國;劉雙又;張耀東;孫燕;熊昊;;兒童噬血細胞綜合征死亡相關因素分析[J];臨床兒科雜志;2010年05期

2 葉t

本文編號：1973607