原发性血小板增多症患者的预后和生存分析  

Prognosis and Survival Analysis of Patients with Essential Thrombocythemia

作　　者：陈沫[1] 侯丽君[1] 刘增香[1] 刘红兵[1] 刘巧丹[1] 

机构地区：[1]中山大学附属第五医院血液科,广东珠海519000

出　　处：《中国实验血液学杂志》2017年第2期510-516,共7页Journal of Experimental Hematology

摘　　要：目的:探讨原发性血小板增多症(ET)患者的预后及生存状态,分析影响该疾病生存的预后因素,为临床诊治和判定预后提供依据。方法:对2002年12月至2013年12月在中山大学附属第五医院和中山市人民医院住院确诊的ET患者进行统计分析,总结其临床特点并进行生存曲线分析及多因素分析,寻找该疾病的生存特点及影响预后的危险因素。结果:118例ET患者的生存情况为1年生存率95.5%,3年生存率92.6%,5年生存率89%,10年生存率81.6%。Kaplan-Meier法生存分析提示年龄≥60岁、有心血管危险因素、既往有血栓或出血病史、贫血(血红蛋白<120 g/L)、血小板计数升高(≥1 000×109/L)、疾病危险分级、高危组中使用羟基脲或/和高三尖杉酯碱对生存率的影响有统计学意义(P<0.05)。COX回归分析显示,未发现影响生存率的独立危险因素。结论:ET患者的生存率高,生存时间长,转化为骨髓纤维化和白血病的风险低,年龄≥60岁、有心血管疾病危险因素、既往有血栓或出血病史、贫血、血小板计数升高是影响预后的危险因素。Objective： To investigate the survival status and prognosis of patients with essential thrombocythemia （ET） and analyze the prognostic factors for the patients＇survival, so as to provide a evidence for clinical treatment and prognosis evaluation. Methods： A retrospective analysis of 118 patients with ET was conducted in the Fifth Affiliated Hospital of Sun Yat-Sen University and Zhongshan Municipale People＇s Hospital from December 2002 to December 2013. The clinical characteristics were summarized, such as the survival curve and multi-factor analysis, therefore looking for the disease characteristics and risk factors affecting the survival and prognosis. Results： Among 118 ET patients enrolled in this study, the survival rate of ET patients for 1, 3, 5 and 10 years were 95.5% ,92.6% ,89% and 81.6%, respectively. Kaplan-Meier survival curve showed that the age i〉60 years old at diagnosis, cardiovascular risk factors, anamnesis of thrombosis or hemorrhage, anemia（ hemoglobin 〈 120 g/L）, thrombocythemia （≥1 000×10^9/L）, risk stratification and hydroxyurea or HHT （hemoharringtonine） use in high-risk group were factors affecting the suvival rate, 7 out of those factors influencing survival rate were statistically significant （ P 〈 0.05 ）. COX regression analysis showed that independent risk factors affecting survival have not yet been found. Conclusion： ET patients display a high survival rate and long survival time, and their conversion risk into the marrow fibrosis or leukemia has been found to be low. The age≥〉 60 years old at diagnosis, cardiovascular risk factors, anamnesis of thrombosis or hemorrhage, anemia and therombocythemia are the risk factors affecting prognosis. The use of hydroxyurea or HHT in high-risk group can improve the prognosis.

关 键 词：原发性血小板增多症 预后因素 生存分析 

分 类 号：R558.3[医药卫生—血液循环系统疾病]