摘要
目的探讨血清钙离子浓度及白蛋白水平在继发性噬血细胞性淋巴组织细胞增多症（sHLH）患者中的临床意义。方法回顾性分析2013年4月至2016年4月收治的68例初诊sHLH患者的临床和实验室资料。将患者按疗效标准分为好转组和进展组，探讨血清钙离子浓度和白蛋白水平在患者中的变化、与其他实验室指标的相关性以及对患者生存的影响，以20例正常体检者为正常对照。结果①与正常对照组比较，淋巴瘤相关性和非肿瘤相关性HLH组患者的血清钙离子浓度、血清白蛋白水平均降低（P值均〈0．05）；与治疗前比较，好转组患者治疗后血清钙离子浓度、血清白蛋白水平均升高（P值均〈0．01），进展组患者治疗后血清钙离子浓度降低（P=0．002），血清白蛋白水平差异无统计学意义（P=0．086）。②初诊时患者血清钙离子浓度与ANC、PLT、HGB呈正相关（P值均〈0．05），与铁蛋白呈负相关（P〈0．05）；初诊时血清钙离子浓度／〉1．92mmol／L组患者的总生存期较〈1．92mmol／L组延长（266d对95d，P=0．006）。③初诊患者血清白蛋白水平与ANC、HGB呈正相关（P值均〈0．05），与铁蛋白呈负相关（P〈0．05）；初诊时血清白蛋白水平≥26．7g／L组患者的总生存期较〈26．7g／L组延长（263d对95d，P=0．023）。④患者组治疗前血清钙离子浓度与血清白蛋白水平呈正相关（P〈0．001），正常对照组无明显相关性（P=0．079）。结论血清钙离子浓度及白蛋白水平在sHLH患者的诊断、指导治疗及疗效监测等方面具有重要意义。
Objective To investigate the clinical significance of serum calcium concentrations albumin levels in patients with secondary hemophagocytic lymphohistiocytosis （sHLH）. Methods and The clinical and laboratory data of 68 patients with newly diagnosed sHLH from April 2013 to April 2016, and 20 bealtby controls were retrospectively analyzed. The patients were classified as the clinical remission group and the progression group according to the response criteria. To explore the changes of serum calcium concentrations and albumin levels in the patients, its correlations with other laboratory indexes and the impact on survival. Results ①The serum calcium concentrations and albumin levels in lympboma- related HLH group and non-tumor HLH group were lower than control group （P 〈 0.05）; The serum calcium concentrations and albumin levels in the clinical remission group after treatment was higher than that before treatment （P 〈 0.01 ）, while in the progression group the serum calcium concentrations after treatment decreased （P=0.002）, the albumin levels did not changed significantly （P= 0.086）. ②The serum calcium concentrations in newly diagnosed sHLH patients was positively correlated with ANC, PLT, HGB （P〈0.05）, and negatively with ferritin （P〈0.05）; The overall survival （OS） was significantly longer in patients with serum calcium concentration≥1.92 mmol/L than that 〈 1.92 mmol/L （266 d vs 95 d,P= 0.006）. ③The serum albumin levels in newly diagnosed sHLH patients was positively correlated with ANC, HGB （P 〈 0.05）, and negatively with ferritin （P 〈 0.05）; The overall survival was longer in patients with serum albumin level/〉 26.7 g/L than that 〈 26.7 g/L （263 d vs 95 d, P = 0.023）. ④The serum calcium concentrations in patients before treatment was positively correlated with serum albumin levels （P 〈 0.001）, and no significant correlation was found in control group （P=0.079）. Conclusion The serum calcium concentrations and albumin levels ha
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2017年第12期1031-1035,共5页
Chinese Journal of Hematology
基金
国家自然科学基金（81570175、81270652）
