Ph染色体/BCR-ABL融合基因阴性骨髓增殖性肿瘤患者不同疗效评价时期的症状负荷评估  

Symptom load assessment of Ph chromosome/BCR-ABL fusion gene negative myeloproliferative tumor patients at different efficacy evaluation periods

作　　者：章志福 汤礼宾 孙洪波 刘军民 罗伟 Zhang Zhifu;Tang Libin;Sun Hongbo;Liu Junmin;Luo Wei(Department of Hematology,People′s Hospital of Longhua District of Shenzhen,Shenzhen 518109,China;Department of Obstetric,People′s Hospital of Longhua District of Shenzhen,Shenzhen 518109,China)

机构地区：[1]深圳市龙华区人民医院血液科,518109 [2]深圳市龙华区人民医院产科,518109

出　　处：《国际肿瘤学杂志》2019年第10期595-600,共6页Journal of International Oncology

基　　金：深圳市卫生计生系统科研项目(201607071)。

摘　　要：目的观察Ph染色体/BCR-ABL融合基因阴性骨髓增殖性肿瘤(MPN)患者不同疾病类型及治疗过程中症状负荷的变化情况。方法选取2017年5月至2019年1月深圳市龙华区人民医院确诊的84例MPN患者,根据其亚型分类将患者分为真性红细胞增多症(PV)组、原发性血小板增多症(ET)组、骨髓纤维化(PMF)组,每组各28例。比较3组患者骨髓增殖性肿瘤总症状评估量表(MPN-SAF-TSS)各维度评分情况,比较不同疗效时期(就诊时、疾病进展时、病情稳定时、临床改善时、部分缓解时、完全缓解时、复发时)肿瘤总症状评估量表各维度评分情况。结果患者初诊时,PV组、ET组、PMF组MPN患者关于饱胀感(χ^2=6.095,P=0.047)、腹部不适(χ^2=7.342,P=0.025)、活动力不佳(χ^2=13.029,P=0.001)、注意力不集中(χ^2=6.099,P=0.047)、瘙痒(χ^2=6.956,P=0.031)、骨痛(χ^2=7.807,P=0.020)、发热(χ^2=8.000,P=0.018)、体重减轻(χ^2=27.340,P<0.001)等症状负荷的发生率差异均具有统计学意义。其中PMF组患者活动力不佳(85.71%,24/28)、注意力不集中(67.86%,19/28)、体重减轻(82.14%,23/28)发生率显著高于PV组[42.86%(12/28)、39.29%(11/28)、35.71%(10/28)]、ET组[(46.43%(13/28)、39.29%(11/28)、14.29%(4/28)](均P<0.05),PMF组患者腹部不适(75.00%,21/28)、骨痛(60.71%,17/28)发生率高于PV组[39.29%(11/28)、25.00%(7/28)](均P<0.05);PMF组饱胀感(89.29%,25/28)、发热(42.86%,12/28)发生率高于ET组[60.71%(17/28)、10.71%(3/28)](均P<0.05);PV组瘙痒发生率(71.43%,20/28)高于ET组(42.86%,12/28)、PMF组(39.29%,11/28)(均P<0.05)。在不同疗效时期,患者乏力(χ^2=368.594,P<0.001)、饱胀感(χ^2=261.312,P<0.001)、腹部不适(χ^2=195.629,P<0.001)、活动力不佳(χ^2=217.862,P<0.001)、注意力不集中(χ^2=280.664,P<0.001)、夜间盗汗(χ^2=239.650,P<0.001)、瘙痒(χ^2=254.418,P<0.001)、骨痛(χ^2=180.291,P<0.001)、发热(χ^2=231.613,P<0.001)、体重减轻(χ^2=227.831,P<0.001)的症状负荷评分,差异均具Objective To observe the disease type and the changes of symptom load during treatment of patients with Ph chromosome/BCR-ABL fusion gene negative myeloproliferative neoplasm(MPN).Methods A total of 84 patients with MPN diagnosed from May 2017 to January 2019 in People′s Hospital of Longhua District of Shenzhen were selected,and were divided into polycythemia vera(PV)group,essential thrombocyhemia(ET)group,and myelofibrosis(PMF)group according to their subtypes,with 28 cases in each group.The scores of MPN-SAF-TSS were compared among the three groups.Besides,the scores of the scale(myeloproliferative neoplasm symptom assessment form total symptom score,MPN-SAF-TSS)in different treatment periods(at the time of the visit,when the disease progressed,when the disease was stable,when the clinical improvement was made,when the partial remission was completed,at the time of remission and recurrence)were also compared.Results At the time of initial diagnosis,there were significant differences in the incidences of symptom burdens among the three groups of MPN patients with abdominal fullness(χ^2=6.095,P=0.047),abdominal discomfort(χ^2=7.342,P=0.025),poor mobility(χ^2=13.029,P=0.001),inattention(χ^2=6.099,P=0.047),pruritus(χ^2=6.956,P=0.031),bone pain(χ^2=7.807,P=0.020),fever(χ^2=8.000,P=0.018)and weight loss(χ^2=27.340,P<0.001).The incidences of poor mobility(85.71%,24/28),inattention(67.86%,19/28)and weight loss(82.14%,23/28)in PMF group were significantly higher than those in PV group[42.86%(12/28),39.29%(11/28),35.71%(10/28)]and ET group[46.43%(13/28),39.29%(11/28),14.29%(4/28)](all P<0.05).The incidences of abdominal discomfort(75.00%,21/28)and bone pain(60.71%,17/28)in PMF group were higher than those in PV group[39.29%(11/28),25.00%(7/28)](both P<0.05).The incidences of abdominal fullness(89.29%,25/28)and fever(42.86%,12/28)in PMF group were higher than those in ET group[60.71%(17/28),10.71%(3/28)](both P<0.05).The incidence of pruritus in PV group(71.43%,20/28)was higher than that in ET group(42.86%,12/28

关 键 词：骨髓肿瘤 骨髓增殖性疾病 真性红细胞增多症 血小板增多 原发性 原发性骨髓纤维化 骨髓增殖性肿瘤总症状评估量表 

分 类 号：R733[医药卫生—肿瘤]