摘要
目的 探讨血清乳酸脱氢酶(LDH)、β2微球蛋白(β2-MG)、铁蛋白(SF)联合改良WHO预后积分系统(WPSS)评分对骨髓增生异常综合征(MDS)预后不良的预测价值.方法 选取110例MDS患者作为研究对象,均检测血清LDH、β2-MG、SF水平.根据生存情况将患者分为病死组与存活组,比较2组血清LDH、β2-MG、SF水平和改良WPSS评分.分析MDS预后不良的危险因素及血清LDH、β2-MG、SF水平和改良WPSS评分单独及联合对MDS预后不良的预测价值.结果 MDS预后不良发生率为40.20％(41/102).病死组血清LDH、β2-MG、SF、改良WPSS评分和染色体核型预后不良比率均高于存活组,差异有统计学意义(P＜0.05). Cox回归模型分析结果显示,血清LDH、β2-MG、SF水平和改良WPSS评分升高、染色体核型预后不良是MDS预后不良的危险因素(P＜0.05).受试者工作特征(ROC)曲线分析结果显示,血清LDH、β2-MG、SF水平联合改良WPSS评分预测MDS预后不良的灵敏度和曲线下面积(AUC)分别为95.12％、0.918,均显著高于各指标单独预测(P＜0.05).结论 血清LDH、β2-MG、SF水平和改良WPSS评分对MDS预后不良均具有一定的预测价值,但4项指标联合预测价值更高.
Abstract
Objective To investigate the value of serum lactate dehydrogenase(LDH),β2-mi-croglobulin(β2-MG)and serum ferritin(SF)combined with the modified WHO-based Prognostic Scoring System(WPSS)score in predicting poor prognosis of patients with myelodysplastic syndrome(MDS).Methods A total of 110 patients with MDS were selected as the research objects,and ser-um levels of LDH,β2-MG and SF were detected.The patients were divided into death group and sur-vival group according to their survival status,and the serum levels of LDH,β2-MG and SF as well as the modified WPSS score were compared between the two groups.The risk factors for poor prognosis in MDS patients and the predictive values of serum LDH,β2-MG,SF and modified WPSS score alone and their combination for poor prognosis in MDS patients were analyzed.Results The incidence of poor prognosis in MDS patients was 40.20％(41/102).The serum levels of LDH,β2-MG and SF,the modified WPSS score,and the ratio of adverse karyotype prognosis in the death group were signifi-cantly higher than those in the survival group(P＜0.05).The results of Cox regression model analysis showed that elevated serum levels of LDH,β2-MG and SF,elevated modified WPSS score,and adverse karyotype prognosis were risk factors for poor prognosis in MDS patients(P＜0.05).The results of receiver operating characteristic(ROC)curve analysis showed that the combination of serum LDH,β2-MG,SF levels and modified WPSS score had a sensitivity of 95.12％and an area under the curve(AUC)of 0.918 for predicting poor prognosis in MDS patients,which were significantly high-er than those of each indicator alone(P＜0.05).Conclusion Serum LDH,β2-MG,SF levels and modified WPSS score have certain predictive value for poor prognosis in MDS patients,but the combined prediction value of the four indicators is higher.
基金项目
河南省中医药科学研究专项(2019JDZX2082)
第七批全国老中医药专家学术经验继承工作指导项目(20230522)
河南省中医药青苗人才项目(豫卫中医函[2021]16号)
维普
万方数据