感染相关噬血细胞综合征的诊治现状

赵鸿; 霍娜; 李俊

doi:10.13201/j.issn.1004-2806.2023.01.002

感染相关噬血细胞综合征的诊治现状

- 北京大学第一医院感染疾病科(北京，100034)

详细信息

作者简介:
赵鸿，北京大学第一医院感染疾病科教授，主任医师，研究生导师，研究室主任，肝病专业药理基地秘书，北京大学第一医院伦理委员会委员。担任中华医学会感染病学分会常务委员、副秘书长；北京医学会感染病学分会副主任委员、常务委员；中国初级卫生保健基金会感染病和肝病专业委员会副主任委员，中国医疗保健国际交流促进会临床微生物和感染分会常务委员，中国研究型医院学会感染病专业委员会常务委员，中国研究型医院学会肝病专业委员会常务委员，北京医师协会感染病专家委员会常务委员。主要从事肝病、不明原因发热等的临床诊治和基础研究。主持或参与多项国家自然科学基金、科技重大专项课题，发表百余篇论文

通讯作者: 赵鸿，E-mail：zhaohong_pufh@bjmu.edu.cn

中图分类号: R55

收稿日期: 2022-12-05

刊出日期: 2023-01-01

Diagnosis and treatment of infection-associated hemophagocytic lymphohistiocytosis

- Department of the Infection Diseases, Peking University First Hospital, Beijing, 100034, China

More Information

Corresponding author: ZHAO Hong, E-mail: zhaohong_pufh@bjmu.edu.cn

Received Date: 05 December 2022

Publish Date: 01 January 2023

摘要

摘要: 继发性噬血细胞综合征中，32.8%~50.4%的诱因为感染。病毒，尤其是人类疱疹病毒，是最常见的病原类型。传统检测技术联合病原宏基因组检测有助于提高病原微生物的检出率，但需结合病情判定检出病原微生物和疾病间的因果关系。发热、外周血两系降低伴无其他原因的脾大、肝损伤，需警惕感染相关噬血细胞综合征。抗感染治疗是感染相关噬血细胞综合征的基础治疗。需根据病情和病原学特点制订“个体化”综合治疗方案。该文综述感染相关噬血细胞综合征的常见病原微生物种类、治疗及预后，以期提高临床救治率。
- 感染相关噬血细胞综合征 /
- 诊断 /
- 治疗
Abstract: Infection accounts for 32.8%-50.4% of secondary hemophagocytic syndrome. Viruses, especially human herpesvirus, are the most common pathogenic type. Traditional techniques combined metagenomic next-generation sequencing is helpful to find the pathogens, but it is necessary to determine the causal relationship between pathogens and infection-associated hemophagocytic lymphohistiocytosis(IAHLH). Awareness of IAHLH is crucial when patients with infection have unknown splenomegaly and/or liver dysfunction, fever and cytopenia. Anti-infection therapy is the basic treatment of IAHLH. "Tailored" therapy regime is based on the severity of the individual and the characteristics of the pathogen. It reviews the common pathogenic, therapy regime and prognosis of IAHLH, for the improvement of early diagnosis and survival rate.
- infection-associated hemophagocytic lymphohistiocytosis /
- diagnosis /
- treatment

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图 1 IAHLH的诊疗流程

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