Uchino Kaori, Nakagami Yuya, Enomoto Megumi, Shimizu Nozomi, Kondo Kenichi, Yamamoto Takahiro, Sugita Yukie, Isaji Yuto, Saigusa Sakura, Iida Yusuke, Shinohara Saki, Horio Tomohiro, Murakami Satsuki, Mizuno Shohei, Ikegame Kazuhiro, Hanamura Ichiro, Takami Akiyoshi
Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.
Hematopoietic Cell Transplantation Center, Aichi Medical University Hospital, Nagakute, Japan.
Int J Hematol. 2025 Aug 12. doi: 10.1007/s12185-025-04050-9.
Functional hyposplenism, defined as impaired splenic function in the absence of splenectomy, increases susceptibility to life-threatening infections. Although Howell-Jolly bodies (HJBs) are well-established markers for this condition, the predictive value of spleen volume for infection risk remains unclear. We retrospectively analyzed 95 non-splenectomized patients with HJBs from 2014 to 2024. We measured spleen volume by computed tomography and compared results with ideal values. We evaluated the associations between splenic volume and infections using univariate and multivariate logistic regression analyses. The median patient age was 66 years (range, 16-95); 72% were male. The median spleen volume was 34 mL, lower than the ideal median of 210 mL. Forty-eight percent of patients experienced at least one infection. Univariate analysis identified age ≥ 65 years and spleen volume < 34 mL as significantly associated with sepsis. Both factors remained independent predictors in multivariate analysis (age ≥ 65: odds ratio [OR], p = 0.039; spleen volume < 34 mL: OR 3.0, p = 0.047). Age ≥ 65 also predicted any infection (OR 3.1, p = 0.013), while low spleen volume demonstrated a trend toward significance (OR 2.2, p = 0.064). In non-splenectomized patients with HJBs, reduced spleen volume and older age independently increase susceptibility to sepsis. Computed tomography-based measurements may help identify functional hyposplenism and guide targeted prophylactic measures.
功能性脾功能减退定义为在未进行脾切除术的情况下脾功能受损，会增加发生危及生命感染的易感性。尽管豪-乔小体（HJBs）是这种情况的公认标志物，但脾脏体积对感染风险的预测价值仍不明确。我们回顾性分析了2014年至2024年95例有豪-乔小体的非脾切除患者。我们通过计算机断层扫描测量脾脏体积，并将结果与理想值进行比较。我们使用单因素和多因素逻辑回归分析评估脾脏体积与感染之间的关联。患者年龄中位数为66岁（范围16 - 95岁）；72%为男性。脾脏体积中位数为34毫升，低于理想中位数210毫升。48%的患者至少经历过一次感染。单因素分析确定年龄≥65岁和脾脏体积<34毫升与脓毒症显著相关。在多因素分析中，这两个因素仍然是独立的预测因素（年龄≥65岁：比值比[OR]，p = 0.039；脾脏体积<34毫升：OR 3.0，p = 0.047）。年龄≥65岁也可预测任何感染（OR 3.1，p = 0.013），而脾脏体积低显示出有显著趋势（OR 2.2，p = 0.064）。在有豪-乔小体的非脾切除患者中，脾脏体积减小和年龄较大独立增加了脓毒症的易感性。基于计算机断层扫描的测量可能有助于识别功能性脾功能减退并指导有针对性的预防措施。
