论文部分内容阅读
目的 :探讨恶性组织细胞病 (恶组 )的临床特点 ,以便早期诊断 ,早期治疗。方法 :回顾性分析 3 0例恶组患者的临床及相关实验室资料。结果 :本组患者中 ,发热 3 0例 ( 10 0 % ) ,贫血表现 2 5例 ( 83 3 % ) ,肝大2 1例 ( 70 % ) ,脾大 15例 ( 5 0 % ) ,全身浅表淋巴结肿大 15例 ( 5 0 % ) ,其中有 2例出现神经精神症状。实验室检查贫血 2 4例 ( 83 3 % ) ,白细胞减少 15例 ( 5 0 % ) ,血小板减少 19例 ( 63 3 % )。所有患者均有组织学证据 ,如骨髓穿刺 (骨穿 )、淋巴结活检等 ,首次骨穿的阴性率 5 5 6% ,无 1例行骨髓活检。 3 0例中仅 2例行联合化疗 ,1例经 5个疗程化疗方案后部分缓解 ,后失访 ,另 1例行 1个疗程COP(环磷酰胺 ,长春新碱 ,强的松 )方案化疗 ,出现弥漫性血管内凝血 (DIC)死亡。其余 2 8例因全身衰竭或死亡或放弃治疗。结论 :临床上有发热、贫血、肝、脾或淋巴结肿大 ,实验室检查有三系减少者 ,要高度怀疑恶组 ,须尽早、多部位行骨穿或组织学活检 ,以利早期确诊。
Objective: To investigate the clinical features of malignant histiocytosis (malignant group) for early diagnosis and early treatment. Methods: A retrospective analysis of 30 patients with malignant group of clinical and laboratory data. Results: 30 cases (100%) of fever, 25 cases (83.3%) of anemia, 21 cases of hepatomegaly (70%), 15 cases of splenomegaly (50%) were superficial Fifteen cases (50%) had lymphadenopathy, of which 2 had neuropsychiatric symptoms. Laboratory tests showed anemia in 24 cases (83.3%), leukopenia in 15 cases (50%) and thrombocytopenia in 19 cases (63.3%). All patients had histological evidence, such as bone marrow puncture (bone wear), lymph node biopsy, the first bone wear rate of 566%, no routine bone marrow biopsy. Only 3 of the 30 patients received combination chemotherapy, one of them was partially relieved after 5 courses of chemotherapy and then lost to follow-up. The other 1 patient received a course of chemotherapy of COP (cyclophosphamide, vincristine, prednisone) , There was diffuse intravascular coagulation (DIC) death. The remaining 28 patients either died of systemic failure or gave up treatment. Conclusion: Clinical fever, anemia, liver, spleen or lymph nodes, laboratory tests have three lines to reduce those who have a high degree of suspicion of evil, as soon as possible, multi-line or bone biopsy biopsy to facilitate the early diagnosis.