Correlation Analysis Of IL-6,hs-CRP And PCT With Hemophagocytic Syndrome And Analysis The Clinical Features

PART 1 Clinical analysis of 38 patients with hemophagocytic syndromeObjective:To investigate the clinical features,the characteristics of laboratory findings,treatment and prognosis of hemophagocytic syndrome.Methods:A retrospective study was performed to analyze the clinical data of 38 patients with hemophagocytic syndrome in Gansu Provincial Hospital and Lanzhou General Hospital of Lanzhou military command from January 2014 to December 2016.Results:1.Among the 38 patients with HLH,21 cases(55.26%)were male,while 17 cases(44.74%)were female.The diagnosed age ranged from 0.58 to 74 years.8 cases were primary hemophagocytic syndrome(p HPS),the median age was 2.5 years,while 30 cases were secondary hemophagocytic syndrome(s HPS),the median age was 46.5years.2.38 patients when they were definitely diagnosed with HLH,the main clinical manifestations were fever(100.00%),hepatomegaly(57.89%),respiratory symptoms(52.63%),splenomegaly(50%)and superficial lymph node enlargement(36.84%).The remaining clinical manifestations were jaundice(34.21y%),skin rash(21.05%),gastrointestinal symptoms(15.79%)and central nervous system symptoms(7.89%).3.38 patients when they were definitely diagnosed with HLH,the main laboratory results were serum ferritin≥500μg/L(100.00%),decreasing of two or more cell lineage in the peripheral blood(89.47),finding the hemphagosis in the bone marrow(68.42%),fastin triglyceride≥3.0mmol/L(55.26%)and fibrinogen≤1.5g/L(50%).Among 38 patients with HLH,9 cases decreasing in absolute count and percentage of NK cells,weighted at 81.82 percent.4.The treatment of 38 patients with HLH were as follows: 6 cases used "HLH-2004" regimen.8 cases only received chemotherapy with dexamethasone and cyclosporin A refer to the “HLH-2004”regimen because of economic reasons,3 cases whose condition required for plasma exchange,then,among which,two cases used "HLH-2004" regimen while 1 case only received chemotherapy with dexamethasone and cyclosporin A because of family reasons.11 cases only used dexamethasone because of economic reasons.2 case secondary to lymphoma separatelly received CHOP and SMILE regimen chemotherapy.5 cases only gave anti-infection,and symptomatic and supportive treatment.3 cases gave up treatment due to economic reasons.5.The treatment of 38 patients with HLH were as follows: There were 16 cases at NAD state,4 cases at AD state,6 cases at RD state,13 cases died,and 6 cases lost to follow-up.The overall NAD rate of 38 patients was 42.1%.17 cases used "HLH-2004" regimen and chemotherapy with dexamethasone and cyclosporin A refer to the “HLH-2004” regimen immediately after definitely diagnosed with HLH,there were 13 cases at NAD state,the NAD rate was 76.47%Conclusions:1.In our group of 38 patients with HLH,the clinical manifestations that appear more frequently are fever,hepatomegaly,respiratory symptoms,splenomegaly and superficial lymph node enlargement,while the laboratory examinations are increasing of serum ferritin,decreasing of two or more cell lineage of peripheral blood,finding of hemphagosis in the bone marrow,fasting triglyceride≥3.0mmol/L and fibrinogen≤1.5 g/L.2.When making a diagnosis of HLH,the detection of absolute count and percentage of NK cells have great significance,cytokines that are associated with cytotoxic activity of NK cells is worth for further study.3.The patients used “HLH-2004”regimen and chemotherapy with dexamethasone and cyclosporin A refer to the “HLH-2004”regimen can obtain a higher NAD rate.PART 2 Correlation analysis of IL-6,hs-CRP and PCT with hemophagocytic syndromeObjective:To evaluate serum IL-6,hs-CRP and PCT for the value of early diagnosis and progonsis of hemophagocytic syndrome.Methods:A total of 38 patients with HPS were selected as case group from 2014 to 2016 in Gansu Provincial Hospital and Lanzhou General Hospital of Lanzhou military command and 30 healthy people were selected as control group at the same time.Serum levels of IL-6 hs-CRP and PCT were compared between the two groups.Results:Serum levels of IL-6,hs-CRP and PCT of case group were statistically significantly higher than those of control group(p<0.05).In cases group,serum levels of IL-6hs-CRP and PCT of patients at acute phase were statistically higher than patients at remission phase(p<0.05).serum levels of IL-6 of dead patients were statistically significantly higher than those of survival patients(p<0.05),while no statistically significant differences of serum level of hs-CRP and PCT was found in survival and dead of patients(p<0.05).Serum levels of IL-6,hs-CRP and PCT of patients with different prognosis are downregulated along with the progression of the disease,and the serous levels of IL-6,hs-CRP and PCT in DR group decreased faster than those of the non-DR during the progression of the disease.The level changes of in two group are all statistically significant(p<0.05).Conclusions:1.Serum levels of IL-6,hs-CRP and PCT arre obviously increased in patients with HLH.The level compared with healthy people are all statistically significant(p<0.05),monitoring of their serum levels is helpful to diagnose HLH.2.The expression levels of IL-6 in serum are closely associated with the severity of HLH.The higher the levels of IL-6 are,the more severe the HLH appear to be,the worse the prognosis.3.Serum levels of IL-6,hs-CRP and PCT are downregulated within the first 2weeks of treatment,thelevel changes of IL-6,hs-CRP and PCT can be used to monitor the prognosis of disease.