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目的:探讨类白血病反应(LKR)的病因,转归及误诊原因。方法:对锦州市儿童医院2008/2009年共15例的患儿进行临床分析。结果:脓毒血症9例,CMV感染4例,1例自身免疫性溶血性贫血,1例活动性结核病。其中脓毒症中有2例骨穿出现早幼粒细胞比例升高,高度怀疑恶性血液病。后经积极抗感染治疗20 d后血象基本恢复正常。所有病例经积极治疗原发病数天至1个月左右,血象基本均恢复正常。结论:类白血病反应的病因较多,注意与白血病的鉴别,避免误诊。类白血病的转归取决于它的原发病,基本上除肿瘤外其他的转归均很好。
Objective: To investigate the etiology, prognosis and misdiagnosis of leukemia-like response (LKR). Methods: A total of 15 children in Jinzhou Children’s Hospital from 2008 to 2009 were analyzed. Results: Sepsis in 9 cases, CMV infection in 4 cases, 1 case of autoimmune hemolytic anemia, 1 case of active tuberculosis. Among them, 2 cases of sepsis had a higher proportion of promyelocytic cells and a higher suspicion of hematologic malignancies. After 20 days after active anti-infective treatment, the blood picture returned to normal. All cases were actively treated for several days to primary disease a few months or so, the basic blood returned to normal. Conclusion: The causes of leukemia-like reactions are more, pay attention to the identification of leukemia, to avoid misdiagnosis. Leukemia depends on the outcome of its primary disease, basically other than cancer, the outcome is very good.