ABSTRACT
Objective:This study aimed to achieve the early diagnosis and active treatment of adult hemophagocytic syndrome (HPS) and investigate the clinical characteristics and prognostic factors of this syndrome. Methods:A single-center retrospective analysis was performed to analyze clinical characteristics, laboratory findings, and survival data. Results:In 58 patients, the most common clinical manifestations were fever (100%) and splenomegaly (89.7%). The most common laboratory parameters were serum ferritin 500 g/L (100%) and peripheral cytopenia in two or more lineages (96.6%). platelet count, fibrinogen, and lactate dehydrogenase in the death group were significantly lower than in the survival group (P=0.000, 0.001, and 0.000). Survival analysis results showed that infections in the rheu-matological group exhibited good prognosis [the overall survival (OS) time was not reached in 190 d]. Patients with unexplained causes had moderate prognosis (OS time was 60 d);tumor-associated HPS patients had poor prognosis (the OS time was only 30 d). Univariate analysis results showed that patients with Fbg<1.5 g/L, PLT<40×109/L, and LDH≥2000 U/L also exhibited poor prognosis (P=0.000). Multivariate analysis results showed that PLT<40 × 109/L was an independent adverse factor (HR=6.472, 95%CI:1.526-26.065, P=0.011). Conclusion:HPS exhibits complex clinical manifestations and varied etiology. Patients with infection and rheumatism-related HPS had good prognosiss compared with those manifesting tumor-associated HPS. Fbg<1.5 g/L, PLT<40×109/L, and LDH≥2 000 U/L were the univariate factors that affected the survival time of patients. PLT<40×109/L is an independent adverse factor. These patients need systemic treatments as early as possible.
ABSTRACT
Objective To observe the influence of total glucosides of peony (TGP) combined with leflunomide on serum level of TNF-α,IL-8 in the patients with psoriatic arthritis(PsA) ,to evaluate its efficacy and safety and to preliminarily study its action mechanism .Methods The open clinical study was adopted .36 patients with PsA were treated by TGP combined with leflunomide for 12 weeks .at the same time 20 healthy control were selected .The double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was adopted to detect the level of serum TNF-α and IL-8 before treatment and in 12 weeks after treatmention the two groups .The Psoriasis Area And Severity Index (PASI) was adopted as the main effective index and the Health Assessment Ques-tionaire(HAQ) was taken as the secondary effective index .The level of CRP ,ESR ,TNF-α,IL-8 before and after treatment were an-alysed .Results The serum TNF-α,IL-8 levels before therapy in the poriatic arthritis group were significantly higher than those in the normal control group(P0 .05) .Conclusion TGP combined leflunomide for treating PsA has better effect and better safety ,which could play the role by influencing serum TNF-α,IL-8 levels .