多发性骨髓瘤患者中性粒细胞与淋巴细胞比值与预后的关系  

Neutrophils and lymphocytes ratio on the prognosis of patients with multiple myeloma

作　　者：孙磊[1,2,3] 王会平[1,2] 熊术道[1,2] 张翠[1,2] 杨冬冬[1,2] 郭进京[1,2] 翟志敏[1,2] 

机构地区：[1]安徽医科大学第二附属医院血液内科,合肥230061 [2]安徽医科大学血液病研究中心,合肥230061 [3]安徽医科大学附属六安医院(六安市人民医院)检验科,六安237005

出　　处：《安徽医科大学学报》2016年第5期721-724,共4页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金项目(编号:81141104);安徽高校省级自然科学研究重大项目(编号:KJ2014Z017)

摘　　要：目的探讨外周血中性粒细胞与淋巴细胞比值(NLR)在多发性骨髓(MM)患者预后中的价值。方法以62例初诊MM患者和81例正常者为研究对象,根据血常规结果计算得出NLR,比较NLR的差异;并以均值2.61为临界值,将MM患者分为低NLR组(NLR≤2.61)和高NLR组(NLR>2.61),然后分析两组患者在性别、年龄、血红蛋白(Hb)、血清钙(Ca)、血清β_2微球蛋白(β_2-MG)、血清白蛋白(ALB)、血清肌酐(Cr)、国际分期标准(ISS)和总体生存期(OS)方面的差异。生存分析采用Kaplan-Meier法和Logrank检验,危险因素分析采用Cox比例风险回归模型。结果 MM患者NLR水平高于对照者(t=2.54,P<0.05)。与低NLR组相比,高NLR组血清β_2-MG和Cr偏高、ISS分期偏晚、总体生存期短,差异均有统计学意义(P<0.05)。Cox单因素及多因素分析结果显示,NLR>2.61是影响患者预后的独立危险因素之一(P<0.05)。结论 MM患者外周血NLR升高提示预后不良,是影响预后的一个独立危险因素。Objective To evaluate the relationship between the neutrophils and lymphocytes ratio（NLR） and prog- nosis in patients with multiple myeloma（MM）. Methods The population that we studied consisted of 62 patients with multiple myeloma and 81 healthy controls. The NLR was calculated according to the results of blood routine examination and compared between patients and healthy controls. The patients were divided into low NLR group （NLR~〈2.61） and high NLR group（NLR 〉2.61 ）. Age and sex composition, the serum concentrations of Hemo- globin（Hb） , calcium（Ca） , beta 2 microspheres J32-MG） , albumin（ALB） and ereatinine（Cr）, and International Staging System（ISS） and overall survival （OS） condition were compared between the above two groups. The im- pacts of NLR on OS were analyzed by Kaplan-Meier and Log-rank test, and the independent prognostic relevance of NLR was analyzed by univariate and multivariate Cox regression. Results The average NLR value of MM group was significantly higher than in healthy control（ t = 2.54 ,P 〈 0. 05 ）. The serum levels of β2-MG and Cr were higher, the ISS was later and the overall survival time was shorter in high NLR group than that in low NLR group （P 〈 0.05 ）. Univariate and multivariate Cox regression analysis showed that NLR 〉 2. 61 was an independent prognostic factor（P 〈 0. 05 ）. Conclusion The increase of NLR in peripheral blood is an independent risk factor for prognosis of patients with MM.

关 键 词：多发性骨髓瘤 中性粒细胞与淋巴细胞比值 预后 

分 类 号：R551.3[医药卫生—血液循环系统疾病]