Article(id=1198558170584023841, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198558165093675863, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.0363.2024.0625, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1710950400000, receivedDateStr=2024-03-21, revisedDate=null, revisedDateStr=null, acceptedDate=1713974400000, acceptedDateStr=2024-04-25, onlineDate=1763688136001, onlineDateStr=2025-11-21, pubDate=1724774400000, pubDateStr=2024-08-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1763688136001, onlineIssueDateStr=2025-11-21, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1763688136001, creator=13701087609, updateTime=1763688136001, updator=13701087609, issue=Issue{id=1198558165093675863, tenantId=1146029695717560320, journalId=1189873630562394117, year='2024', volume='49', issue='8', pageStart='855', pageEnd='976', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1763688134691, creator=13701087609, updateTime=1763689174168, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1198562525043327039, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198558165093675863, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1198562525043327040, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198558165093675863, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=952, endPage=958, ext={EN=ArticleExt(id=1198558170881819438, articleId=1198558170584023841, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Advances in diagnosis and treatment of adult hemophagocytic syndrome, columnId=1190243275882729994, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Review, runingTitle=null, highlight=null, articleAbstract=
Hemophagocytic syndrome (HPS), also known as hemophagocytic lymphohistiocytosis (HLH), is a rare and highly malignant hematologic disease with a poor prognosis. It can be divided into two categories: primary HLH and secondary HLH. HLH is characterized by a large number of abnormal immune cells that continuously activate and regulate out of control, leading to systemic inflammatory factor storm and multiple organ failure. Clinical manifestations mainly include persistent malignant hyperthermia, pancytopenia, hepatosplenomegaly, and hemophagocytosis in tissues and organs. The pathogenesis of adult HLH is complex, with rapid onset and rapid disease progression, and the fatality rate remains high. The main causes of death in HLH patients are multiple organ failure, abnormal coagulation and septic shock. Due to the specificity of HLH and the lack of effective understanding of the severity and prognosis in clinical practice, some HLH patients are misdiagnosed or overlooked, missing the best opportunity for diagnosis and treatment. Therefore, this review systematically explores and discusses the latest diagnostic and treatment progress of adult HLH, aiming to provide reference for clinical diagnosis, treatment and prognosis assessment of HLH.
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作为临床较罕见且预后差的恶性血液病,噬血细胞综合征(HPS)亦被称为噬血细胞性淋巴组织细胞增生症(HLH),可分为原发性(遗传性)HLH和继发性(获得性)HLH两类,其特征为大量异常的免疫细胞持续激活与调节失控,进而导致全身性炎性因子风暴和多器官衰竭,临床表现主要为持续恶性高热、全血细胞减少、肝脾大和组织器官发生噬血现象等。成人HLH致病诱因复杂,起病急骤,病情进展迅速,病死率居高不下,多器官衰竭、出凝血异常及脓毒性休克是患者死亡的重要原因。由于疾病的特殊性以及临床实践中对病情严重性和预后判断缺乏有效认识,导致部分HLH患者被漏诊、误诊,继而错过最佳诊疗时机。本文针对成人HLH诊断与治疗的新进展进行系统性综述,旨在为HLH的临床诊疗、预后评估等提供借鉴与参考。
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刘彦权,医学博士,主治医师,主要从事恶性血液病的科研与临床以及高等医学教育研究
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1Department of Hematology, the First School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1198578973115511422, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, authorId=1198578972897407605, language=CN, stringName=刘彦权, firstName=彦权, middleName=null, lastName=刘, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=
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1广东医科大学第一临床医学院血液内科,广东东莞 523808, bio={"content":"
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2Department of Hematology, the Affiliated Hospital of Putian University, Putian, Fujian 351100, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1198578973392335500, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, authorId=1198578973191008898, language=CN, stringName=陈晓君, firstName=晓君, middleName=null, lastName=陈, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=
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2莆田学院附属医院血液科,福建莆田 351100, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1198578972628972138, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, xref=2, ext=[AuthorCompanyExt(id=1198578972641555051, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, companyId=1198578972628972138, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=
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3Department of Anatomy, School of Basic Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1198578973643993753, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, authorId=1198578973488804497, language=CN, stringName=曾敏娟, firstName=敏娟, middleName=null, lastName=曾, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=
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3广东医科大学基础医学院解剖学教研室,广东东莞 523808, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1198578972729635437, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, xref=3, ext=[AuthorCompanyExt(id=1198578972738024046, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, companyId=1198578972729635437, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=
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4Department of Hematology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1198578973883069092, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, authorId=1198578973723685532, language=CN, stringName=沈建箴, firstName=建箴, middleName=null, lastName=沈, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=
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4福建医科大学附属协和医院血液科,福建福州 350001, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1198578972826104432, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, xref=4, ext=[AuthorCompanyExt(id=1198578972830298737, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, companyId=1198578972826104432, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=
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4福建医科大学附属协和医院血液科,福建福州 350001)])])], keywords=[Keyword(id=1198578974101172903, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, language=EN, orderNo=1, keyword=hemophagocytic syndrome), Keyword(id=1198578974155698859, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, language=EN, orderNo=2, keyword=malignant hematological diseases), Keyword(id=1198578974281527984, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, language=EN, orderNo=3, keyword=diagnosis and differentiation), Keyword(id=1198578974357025460, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, language=EN, orderNo=4, keyword=treatment), Keyword(id=1198578974415745718, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, language=EN, orderNo=5, keyword=prognosis), Keyword(id=1198578974499631803, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, language=CN, orderNo=1, keyword=噬血细胞综合征), Keyword(id=1198578974591906495, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, language=CN, orderNo=2, keyword=恶性血液病), Keyword(id=1198578974717735616, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, language=CN, orderNo=3, keyword=诊断与鉴别), Keyword(id=1198578974805816003, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, language=CN, orderNo=4, keyword=治疗), Keyword(id=1198578974914867908, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, language=CN, orderNo=5, keyword=预后)], refs=[Reference(id=1198578975862780642, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, doi=null, pmid=null, pmcid=null, year=2020, volume=34, issue=4, pageStart=101515, pageEnd=null, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=Griffin G, Shenoi S, Hughes GC, journalName=Best Pract Res Clin Rheumatol, refType=null, unstructuredReference=
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Diagnostic mechanism and roadmap of adult hemophagocytic lymphohistiocytosis (hemophagocytic syndrome), figureFileSmall=ruzLCgfDW54BbXpRDSJWMw==, figureFileBig=TKz+DKfoL+Veuy/m8iR9VA==, tableContent=null), ArticleFig(id=1198578975254606538, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558170584023841, language=CN, label=图1, caption=
成人噬血细胞性淋巴组织细胞增多症(噬血细胞综合征)诊断流程HLH. 噬血细胞性淋巴组织细胞增多症(噬血细胞综合征);SF. 铁蛋白;TG. 三酰甘油;FIB. 纤维蛋白原;sCD25. 可溶性白细胞介素-2受体;NK. 自然杀伤;3/8、4/8、5/8分别指符合HLH-2004版诊断标准8项指标中的3项、4项和5项
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