体质量指数与成人急性髓系白血病关系的分析  

The Relationship between Body Mass Index and Adult Acute Myeloid Leukemia

作　　者：王艳娜[1] 魏同 席亚明[2] 杨明月 牛路 王小玲 WANG Yan-Na;WEI Tong;XI Ya-Ming;YANG Ming-Yue;NIU Lu;WANG Xiao-Ling(The First Clinical Medical College of Lanzhou University,Gansu Province,China;Department of Hematology,Lanzhou University First Hospital,Lanzhou 730000,Gansu Province,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]兰州大学第一医院血液科,甘肃兰州730000

出　　处：《中国实验血液学杂志》2021年第3期677-684,共8页Journal of Experimental Hematology

摘　　要：目的:分析不同体质量指数(BMI)与成人初诊急性髓系白血病(AML)患者的临床特征、实验室检查指标的关系及对首次诱导化疗效果的影响。方法:回顾性分析兰州大学第一医院血液科2015年8月至2019年8月初诊的成人AML患者145例(急性早幼粒细胞白血病除外)的临床资料。根据中国成人超重和肥胖症预防控制指南,计算入选的AML患者诱导化疗前的BMI(kg/m^(2))值,分为低体质量组(BMI <18.5)、正常体质量组(18.5≤BMI≤23.9)、超重及肥胖组(BMI≥24)。收集患者性别、年龄、危险分层、白血病类型、基因突变、合并症、住院时间等临床特征,白细胞(WBC)、血红蛋白(Hb)、白蛋白(ALB)、甘油三脂(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、乳酸脱氢酶(LDH)等实验室指标,粒缺性发热、病原学感染、粒细胞缺乏持续时间、明显出血、肝肾毒性等化疗相关不良反应指标以及患者的形态学缓解情况。诱导化疗方案均为标准化疗方案(蒽环类药物联合阿糖胞苷)。结果:共纳入患者145例,男71例(49%),女74例(51%),中位年龄50(18-82)岁。其中低体质量组21例(14.5%),正常体质量组79例(54.5%),超重及肥胖组45例(31.0%)。BMI级别越高的患者年龄越大(P=0.018);各组之间的性别比较有统计学差异(P=0.035),超重及肥胖患者中,男性明显多于女性;AML分型、化疗前合并症(糖尿病、高血压、冠心病)、住院时间、继发性AML、FLT3基因突变、危险分层方面无显著差异。不同BMI分组在TG上有显著差异,而超重及肥胖的患者更高(P=0.007);初诊时WBC、Hb、ALB、TC、HDL、LDL、LDH在计数上无显著差异。低体质量组、超重及肥胖组的完全缓解率均明显低于正常体质量组(P=0.035);首次诱导化疗,低体质量组出现明确病原学感染率均明显高于正常体质量组和超重及肥胖组(P=0.038);BMI分组在化疗方案、首次获得完全缓解需要的化疗次数Objective:To analysis the relationship between different BMI(body mass index) and the clinical characteristics,laboratory examination indexes of newly diagnosed adult patients with acute myeloid leukemia(AML),so as to investigate the effects of BMI to the efficacy of first induction chemotherapy.Methods:The clinical data of 145 newly diagnosed adult AML patients treated in the First Hospital of Lanzhou University from August 2015 to August2019 were retrospective analyzed.According to the guidelines for prevention and control of overweight and obesity in Chinese adults,the BMI(kg/m^(2)) of the selected AML patients before induction chemotherapy was calculated and the patients were divided into the low body mass group(BMI <18.5),the normal body mass group(18.5≤BMI≤23.9)and the overweight and obese group(BMI≥24).The clinical data of the patients,including sex,age,risk stratification,the types of leukemia,gene mutation,complications,length of hospital stay and other clinical features;white blood cell(WBC),hemoglobin(Hb),albumin,triglyceride(TG),total cholesterol(TC),high-density lipoprotein(HDL),low density lipoprotein(LDL),lactate dehydrogenase(LDH),and other laboratory index;agranulocytosis with fever,infection of etiology,lack of granulocyte duration,significant bleeding,liver and kidney toxicity of chemotherapy adverse reactions associated indicators and Morphological remission were collected.The induction chemotherapy regimen was the standard chemotherapy regimen(anthracyclines combined with cytarabine).Results:Among the 145 newly diagnosed adult AML patients,there were 71 males and 74 females.The median age was 50 years old(range 18 to 82 years old).There were 21 patients in underweight group(14.5%),79 patients in normal weight group(54.5%),and 45 patients in overweight and obese group(31.0%).The patients with higher BMI level showed the older in age(P=0.018).There were significant differences in sex between the patients in each group(P=0.035).In overweight and obese patients,the number of male was signif

关 键 词：体质量指数 成人 初诊 急性髓系白血病 

分 类 号：R733.71[医药卫生—肿瘤]