首页|血清乳酸脱氢酶、β2微球蛋白、铁蛋白联合改良WHO预后积分系统预测骨髓增生异常综合征预后不良的价值

血清乳酸脱氢酶、β2微球蛋白、铁蛋白联合改良WHO预后积分系统预测骨髓增生异常综合征预后不良的价值

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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.
Value of serum lactate dehydrogenase,β2 microglobulin and ferritin combined with modified WHO-based Prognostic Scoring System in predicting poor prognosis of myelodysplastic syndrome
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.

lactate dehydrogenaseβ2-microglobulinferritinmodified WHO-based Prog-nostic Scoring Systemmyelodysplastic syndromeprognosis

万姜维、成东茹、王涛、高萍

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河南中医药大学第一附属医院血液肿瘤科,河南郑州,450000

乳酸脱氢酶 β2微球蛋白 铁蛋白 改良WHO预后积分系统 骨髓增生异常综合征 预后

河南省中医药科学研究专项第七批全国老中医药专家学术经验继承工作指导项目河南省中医药青苗人才项目

2019JDZX208220230522豫卫中医函[2021]16号

2024

10.7619/jcmp.20233107

实用临床医药杂志
扬州大学,中国高校科技期刊研究会

实用临床医药杂志

CSTPCD
影响因子：1.543
ISSN：1672-2353
年,卷(期)：2024.28(5)
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