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急性白血病患者红细胞寿命的影响因素分析

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目的 分析急性白血病(AL)患者不同疾病状态下的红细胞寿命及其影响因素。方法 选取2022年1月至2023年6月就诊于兰州大学第一医院血液科的142例AL患者作为研究对象,收集其红细胞寿命等临床资料,比较不同疾病状态AL患者的红细胞寿命,采用Spearman相关性分析判断红细胞寿命与年龄及其他实验室指标的相关性,采用单因素分析和多元线性回归分析探索AL患者红细胞寿命的影响因素。结果 142例AL患者中初诊33例、复发19例、部分缓解+未缓解8例、完全缓解82例,红细胞寿命分别为33。0(9。0~147。0)、52。0(15。0~115。0)、20。5(12。0~46。0)、50。0(11。0~186。0)d,初诊及部分缓解+未缓解患者红细胞寿命均短于完全缓解患者,差异有统计学意义(Z=-3。933,P<0。001;Z=-3。586,P=0。002)。15例初诊AL患者经治疗后达到完全缓解,红细胞寿命较初诊时明显延长[42(14~101)d vs。27(9~68)d,Z=-2。179,P=0。029]。相关性分析显示,红细胞寿命与白细胞计数、红细胞计数、血红蛋白水平、血小板计数呈正相关(P<0。05),与原始细胞计数、促红细胞生成素水平呈负相关(P<0。05)。多元线性回归分析结果显示,染色体核型异常、FMS样酪氨酸激酶3(FLT3)、RUNX1基因突变和输血是AL患者红细胞寿命的影响因素(B=-11。151、-24。969、-30。838、-18。784,P<0。05)。结论 AL患者不同疾病状态下红细胞寿命均缩短,经治疗达完全缓解后可得到一定程度的恢复,但仍低于正常参考范围。AL患者的红细胞寿命与染色体核型异常、FLT3、RUNX1基因突变和短期内输血有关。
Analysis of influencing factors of red blood cell lifespan in patients with acute leukemia
Objective To analyze the red blood cell lifespan and its influencing factors in patients with acute leukemia (AL) under different disease states.Methods A total of 142 cases of patients with AL admit-ted to the department of hematology in the First Hospital of Lanzhou University from January 2022 to June 2023 were selected as the research subjects,and their red blood cell lifespan and other clinical data were col-lected.The red blood cell lifespan were compared among patients with AL under different disease states. Spearman correlation analysis was used to determine the correlation between the red blood cell lifespan with age and other laboratory indicators,and univariate analysis and multiple linear regression analysis were used to explore the influencing factors of red blood cell lifespan in patients with AL.Results Among the 142 cases of AL,there were 33 newly diagnosed cases,19 relapsed cases,8 cases of partial response+no response,and 82 cases of complete response.The red blood cell lifespan was 33.0 (9.0-147.0),52.0 (15.0-115.0),20.5 (12.0-46.0),50.0 (11.0-186.0) d,respectively.The red cell lifespan of newly diagnosed patients and pa-tients with partial response+no response was shorter than that of patients with complete response,and the differences were statistically significant (Z=-3.933,P<0.001;Z=-3.586,P=0.002).Fifteen newly di-agnosed AL patients achieved complete response after treatment,and the red blood cell lifespan was signifi-cantly prolonged compared with that at initial diagnosis[42 (14-101) d vs. 27 (9-68) d,Z=-2.179,P=0.029].The results of correlation analysis showed that the red blood cell lifespan was positively correlated with white blood cell count,red blood cell count,hemoglobin level and platelet count (P<0.05),and nega-tively correlated with blast cell count and erythropoietin level (P<0.05).The results of multiple linear re-gression analysis showed that the chromosomal abnormalities in karyotypes,FMS-like tyrosine kinase 3 (FLT3),RUNX1 gene mutations and blood transfusion were the influencing factors of red blood cell lifespan in patients with AL (B=-11.151,-24.969,-30.838,-18.784,P<0.05).Conclusion The red blood cell lifespan in patients with AL is shortened under different disease states,which could obtain a certain degree of recovery after achieving complete response after treatment (but still below the normal reference range).The red blood cell lifespan in patients with AL is related to chromosomal abnormalities in karyotypes,FLT3,RUNX1 gene mutations and short term blood transfusion.

acute leukemialife span of red blood celldisease statuscorrelation analysisinfluencing factors

张雪鹏、袁茜、韩帆、席亚明

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兰州大学第一临床医学院,兰州 730000

兰州大学第一医院血液科,兰州 730000

急性白血病 红细胞寿命 疾病状态 相关性分析 影响因素

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(11)