多发性骨髓瘤患者RDW及PLR与预后的关系  

Relationship between RDW and PLR and prognosis in patients with multiple myeloma

作　　者：宫文玉 金其川[1] 鲍文强 Gong Wen-yu;Jin Qi-huan;Bao Wen-qiang(Department of Hematology,Chuzhou No.1 Peopled Hospital,Chuzhou 239000,China)

机构地区：[1]滁州市第一人民医院血液内科,滁州239000

出　　处：《湖南师范大学学报（医学版）》2022年第2期187-191,共5页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:分析多发性骨髓瘤(MM)患者红细胞分布宽度(RDW)、外周血血小板/淋巴细胞比值(PLR)与预后的关系.方法:选取本院2017年8月~2021年6月期间收治的多发性骨髓瘤患者(MM组)68例和同期健康体检者(健康对照组)60例作为主要研究对象,血细胞检查计算出RDW和PLR.ROC曲线得出RDW和PLR诊断MM的最佳截断值,根据最佳截断值将其分为高RDW组、低RDW组和高PLR组、低PLR组,比较各组患者的一般临床资料,并分析RDW、PLR与MM患者预后的关系.结果:MM组的RDW高于健康对照组,PLR低于健康对照组.RDW预测MM的ROC曲线下面积(AUC)为0.821(95%CI:0.747~0.894),其最佳截断值为14.30%;PLR预测MM的ROC曲线下面积(AUC)为0.704(95%CI:0.614~0.795),其最佳截断值为89.95.将MM组患者分为高RDW组(n=39)、低RDW组(n=29)和低PLR组(n=32)、高PLR组(n=36),高RDW组与低RDW组在血红蛋白、血小板计数上差异具有统计学意义,高PLR组与低PLR组在血清白蛋白上差异具有统计学意义.高RDW组中位OS为15个月低于低RDW组的30个月,高PLR组的中位OS为30个月高于低PLR组的13个月,Kaplan-meier生存曲线分析结果显示,高RDW、PLR与低RDW、PLR的MM患者中位OS差异具有统计学意义.结论:MM患者的RDW明显升高,PLR明显降低,RDW与PLR能够作为MM的预后指标,其中高RDW、低PLR的MM患者预后更差.Objective The relationship between Red blood cell distribution width(RDW),the peripheral blood platelet/lymphocyte ratio(PLR)and the prognosis in patients with multiple myeloma(MM)was analyzed.Methods The 68 patients with multiple myeloma(group MM)and 60 patients(control group)with physical examination from August 2017 to 0 June 2021 were selected as the main study subjects,and RDW and PLR were calculated by blood cell examination.The ROC curve yielded the best cutoff value for RDW and PLR diagnostic MM,divided it into high RDW,low RDW and high PLR and low PLR groups according to the best cutoff value,compared the general clinical data of each group,and analyzed the prognosis between RDW,PLR and MM patients.Results In MM,RDW was higher than healthy controls and PLR was lower than healthy controls,and the difference was statistically significant.The RDW ROC area(AUC)of MM is 0.821(95%CI:0.747~0.894)with an optimal cut-off of 14.30%and the ROC area(AUC)of 0.704(95%CI:0.614 to 0.795)of 89.95.MM patients were divided into high RDW(n=39),low RDW(n=29)and low PLR(n=32),high PLR(n=36),high RDW and low RDW,and high PLR and low PLR.The median OS of 15 and 30 months and median OS of 30 and high PLR in the Kaplan-meier survival curve analysis showed a statistically significant difference in median OS between the MM patients with high RDW,low RDW and PLR.Conclusion The RDW of patients with multiple myeloma is significantly increased,and the PLR is significantly decreased.RDW and PLR can be used as prognostic indicators of multiple myeloma,and the prognosis of MM patients with high RDW and low PLR is worse.

关 键 词：多发性骨髓瘤 红细胞分布宽度 外周血血小板/淋巴细胞比值 预后 

分 类 号：R738.1[医药卫生—肿瘤]