营养风险指数对多发性骨髓瘤患者预后的评估价值
Evaluation value of nutritional risk index for the prognosis of patients with multiple myeloma
石利利 1倪增峰 2杨莉洁 1郝彩霞 1梁英民1
作者信息
- 1. 西安国际医学中心医院血液科,西安 710117
- 2. 西安医学院第一附属医院血液内科,西安 710077
- 折叠
摘要
目的 分析营养风险指数(NRI)评估多发性骨髓瘤(MM)患者预后的临床价值.方法 回顾性分析西安国际医学中心医院2019年10月至2020年11月收治的MM患者120例的临床资料,根据NRI分为高NRI组(≥ 83.5)76例和低NRI组(＜83.5)44例,比较两组的生存情况,并利用受试者工作特征(ROC)曲线分析NRI对MM患者预后的预测价值.结果 与高NRI组相比,低NRI组国际分期系统(ISS)分期更晚期,血清C反应蛋白(≤ 10mg/L)、血红蛋白(≤ 120 g/L)和白蛋白(≤ 35 g/L)占比更低[24(54.55％)比 56(73.68％),38(86.36％)比45(59.21％),43(97.73％)比 46(60.53％),x2=4.59、7.21、20.13,均P＜0.05];低NRI组1年、2年及3年生存率均明显低于高NRI组(x2=4.22、37.51、20.38,均P＜0.05),中位总生存期(OS)亦显著低于高NRI组(x2=68.04,P＜0.05);ROC曲线分析结果显示,NRI预测MM患者3年存活的AUC值为0.796,当NRI＞82.35时,预测价值最高,灵敏度、特异度分别为92.98％和53.97％.结论 NRI评分能有效评价初诊MM患者的营养状态,对患者3年内死亡的早期预测具有重要的临床价值.
Abstract
J Objective To analyze the clinical value of nutritional risk index(NRI)in assessing the prognosis of patients with multiple myeloma(MM).Methods The clinical data from 120 patients with MM who received treatment at Xi'an International Medical Center Hospital between October 2019 and November 2020 were retrospectively analyzed.The patients were divided into a high NRI group(NRI ≥ 83.5,n=76)and a low NRI group(NRI＜83.5,n=44)based on their NRI values.The survival outcomes of the two groups were compared,and a receiver operating characteristic curve was used to evaluate the prognostic value of NRI in patients with MM.Results Compared with the high NRI group,the low NRI group had a later stage according to the International Staging System,with lower proportions of patients having serum C-reactive protein(≤10 mg/L),hemoglobin(≤120 g/L),and albumin(≤ 35 g/L)[24(54.55％)vs.56(73.68％),38(86.36％)vs.45(59.21％),43(97.73％)vs.46(60.53％),x2=4.59,7.21,20.13,all P＜0.05].The 1-year,2-year,and 3-year survival rates in the low NRI group were significantly lower than those in the high NRI group(x2=4.22,37.51,20.38,all P＜0.05),and the median overall survival was also significantly lower in the low NRI group(x2=68.04,P＜0.05).Receiver operating characteristic curve analysis indicated that the area under the curve for NRI predicting 3-year survival in MM patients was 0.796.The predictive value was highest when NRI＞82.35,with a sensitivity of 92.98％and specificity of 53.97％.Conclusion The NRI score can effectively assess the nutritional status of newly diagnosed MM patients and has significant clinical value for the early prediction of death within 3 years.
关键词
多发性骨髓瘤/营养状况/预后/预测/ROC曲线Key words
Multiple myeloma/Nutritional status/Prognosis/Forecasting/ROC curve引用本文复制引用
出版年
2024
NETL
NSTL
万方数据