Department of Hematology, Tianjin Medical University General Hospital, Tianjin, China.
J Clin Lab Anal. 2020 Jan;34(1):e23008. doi: 10.1002/jcla.23008. Epub 2019 Sep 10.
We performed a retrospective analysis to investigate the clinical characteristics and therapeutic strategies of Chinese paroxysmal nocturnal hemoglobinuria (PNH) patients, and assessed the efficacy and safety of glucocorticoid in PNH patients.
The clinical data of 92 PNH cases in our hospital were analyzed, including clinical manifestation, laboratory examination, treatment efficacy, and survival.
The main clinical manifestations of these patients included hemoglobinuria, anemia, fatigue, dyspnea, headache, abdominal pain, and erectile dysfunction. Glucocorticoid is still the first-line treatment for PNH patients to control hemolytic attack, and the short-term remission rate (12 months) is 79.01% (64/81). Meanwhile, the overall survival (OS) of 10 years after diagnosis was estimated as 70.77% (46/65). Moreover, Cox proportional risk model for multivariate analysis showed that the increase in LDH multiple, thrombosis complications, and complicated with bone marrow failure were the independent adverse prognostic factors affecting the survival of PNH patients.
Paroxysmal nocturnal hemoglobinuria patients in mainland China have various clinical features, while lower incidences of thrombosis and renal damage. Thrombosis and bone marrow failure are two complications with worse prognosis.
本研究回顾性分析了中国阵发性睡眠性血红蛋白尿症(PNH)患者的临床特征和治疗策略,并评估了糖皮质激素治疗 PNH 患者的疗效和安全性。
分析了我院 92 例 PNH 患者的临床资料,包括临床表现、实验室检查、治疗效果和生存情况。
患者的主要临床表现包括血红蛋白尿、贫血、乏力、呼吸困难、头痛、腹痛和勃起功能障碍。糖皮质激素仍是控制溶血发作的一线治疗药物,短期缓解率(12 个月)为 79.01%(64/81)。同时,诊断后 10 年的总生存率(OS)估计为 70.77%(46/65)。此外,多因素 Cox 比例风险模型分析显示,LDH 倍数增加、血栓并发症和合并骨髓衰竭是影响 PNH 患者生存的独立不良预后因素。
中国大陆 PNH 患者具有多种临床特征,血栓形成和肾脏损害的发生率较低。血栓形成和骨髓衰竭是两种预后较差的并发症。