骨髓增生异常综合征预后影响因素分析  

Analysis of influencing factors on the prognosis of myelodysplastic syndrome

作　　者：王舒[1] 刘冰[1] 关红梅[1] Wang Shu;Liu Bing;Guan Hongmei(Second People's Hospital of Nanyang City,Nanyang 473000,Henan,China)

机构地区：[1]南阳市第二人民医院,河南南阳473000

出　　处：《临床心身疾病杂志》2021年第6期143-146,共4页Journal of Clinical Psychosomatic Diseases

基　　金：南阳市科技人才项目(编号2017056180)。

摘　　要：目的探讨骨髓增生异常综合征预后的影响因素。方法对60例骨髓增生异常综合征患者静脉滴注地西他滨治疗,28 d为1个治疗周期,连续治疗4个周期。随访12个月统计患者病死率。对入组患者的性别、年龄,DNMT3A、TP53、U2AF1、TET2、RUNX1、ASXL1、SRSF2突变情况,白细胞计数、血小板计数、血红蛋白水平等进行单因素和多元logistic回归分析。结果随访12个月入组患者病死12例,病死率为20.0%。单因素分析显示,骨髓增生异常综合征预后情况在ASXL1突变、SRSF2突变、白细胞计数、血小板计数方面存在显著差异(P<0.05),在性别、年龄,DNMT3A、TP53、U2AF1、TET2、RUNX1突变情况及血红蛋白水平方面无明显差异(P>0.05)。多元logistic回归分析显示,ASXL1突变、SRSF2突变、白细胞计数<4×10^(9)·L^(-1)、血小板计数<100×10^(9)·L^(-1)是骨髓增生异常综合征患者病死的影响因素(OR>1,P<0.05)。结论骨髓增生异常综合征预后影响因素包括ASXL1突变、SRSF2突变、白细胞计数<4×10^(9)·L^(-1)、血小板计数<100×10^(9)·L^(-1),可据此预测预后风险制定新的治疗计划,改善预后。Objective To explore the influencing factors on the prognosis of myelodysplastic syndrome(MDS).Methods A total of 60 MDS patients were treated with intravenous infusion of decitabine,28d was taken as a treatment cycle,and treatment was continued for 4 cycles.The fatality rate of the patients was counted after 12 months of follow-up.The gender,age,DNMT3A,TP53,U2AF1,TET2,RUNX1,ASXL1,SRSF2 mutations,white blood cell count(WBC),blood platelet count(BPC),and hemoglobin(HGB)levels of the enrolled patients were analyzed by single factor and multiple logistic regression analysis.Results After 12 months of follow-up,12 patients died,and the fatality rate was 20.0%.Univariate analysis showed that the prognosis of MDS was significantly different in ASXL1 mutation,SRSF2 mutation,WBC and BPC(P<0.05),but there were no significant differences in gender,age,DNMT3A,TP53,U2AF1,TET2,RUNX1 mutations and HGB(P>0.05).Multiple logistic regression analysis showed that ASXL1 mutation,SRSF2 mutation,WBC<4×10^(9)·L^(-1),BPC<100×10^(9)·L^(-1) were the influencing factors for the death of MDS patients(OR>1,P<0.05).Conclusions The prognostic factors of MDS include ASXL1 mutation,SRSF2 mutation,WBC<4×10^(9)·L^(-1) and BPC<100×10^(9)·L^(-1),which can be used to predict prognostic risks and formulate new treatment plans to improve the prognosis.

关 键 词：骨髓增生异常综合征 地西他滨 预后 影响因素 

分 类 号：R551.3[医药卫生—血液循环系统疾病]