老年骨髓增生异常综合征患者的临床预后及影响因素分析  

Clinical prognosis of myelodysplastic syndrome in the elderly and its influencing factors

作　　者：叶佳鑫 钱文斌[1] 

机构地区：[1]浙江大学医学院附属第一医院血液内科,杭州310003

出　　处：《中华老年医学杂志》2017年第9期983-986,共4页Chinese Journal of Geriatrics

摘　　要：目的分析老年骨髓增生异常综合征患者的临床预后及其影响因素。方法纳入2013年1月至2016年8月在我院诊治的老年骨髓增生异常综合征患者36例，Kaplan-Meier法分析患者的生存情况，及性别、年龄、WHO分型、确诊时白细胞计数、血小板计数、血红蛋白量和IPSS分组对患者生存时间的影响，多因素Cox回归模型筛选影响骨髓增生异常综合征患者临床预后的独立危险因素。结果随访至2017年3月31日，随访时间8～31个月。随访期间19例（58．3％）患者死亡，17例（41．7％）患者存活。平均生存（19．17±1．47）个月。Kaplan-Meier生存分析显示年龄、WHO分型、白细胞计数、血小板计数和IPSS分组是影响老年骨髓增生异常综合征患者生存时间的影响因素。多因素Cox回归模型分析结果显示年龄和IPSS分组是影响老年骨髓增生异常综合征患者临床预后的独立危险因素。结论年龄、WHO分型、白细胞和血小板计数和IPSS分组与老年骨髓增生异常综合征患者的临床预后密切相关。Objective To analyze the clinical prognosis and its influencing factors in elderly patients with myelodysplastic syndrome. Methods A total of 36 elderly patients with myelodysp｜astic syndrome were included in this study, who were diagnosed and treated at our hospital from January 2013 to August 2016. The Kaplan-Meier method was used to analyzed the survival of these patients, and the effects of gender, age, WHO classification, white blood cell count, platelet count, hemoglobin and IPSS grouping on survival were analyzed. The independent risk factors associated with the clinical prognosis of patients were identified by using multivariate Cox regression analysis. Results Patients were followed up until March 31,2017 with a follow-up time ranging from 8 to 31 months. During the follow-up period, 19（58.3%）deaths and 17（41.7%） survivals were reported. The average survival time was（19.17±1.47） months. Kaplan-Meier survival analysis showed that age,WHO classification, white blood cell count, platelet count and IPSS grouping were closely associated with survival in elderly patients with myelodysplastic syndrome. Multivariate Cox regression analysis showed that age and IPSS grouping were independent prognostic factors in elderly patients with myelodysplastic syndrome. Conclusions Age, WHO classification, white blood cell count, platelet count and IPSS grouping are closely related to the prognosis of myelodysplastic syndrome in elderly patients.

关 键 词：骨髓增生异常综合征 临床预后 危险因素 

分 类 号：R551.3[医药卫生—血液循环系统疾病]