有核红细胞数在多发性骨髓瘤中的病情诊断与预后预测中的价值  

The Values of the Nucleated Red Blood Cell Count in the Diagnosis and Prognosis of Multiple Myeloma

作　　者：杨莹[1] 王舒[1] 陈宛丽[1] 刘冰[1] 关红梅[1] 姬玉涵 YANG Ying;WANG Shu;CHEN Wan-li;LIU Bing;GUAN Hong-mei;JI Yu-han(Department of Hematological Oncology,Second People's Hospital of Nanyang City,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市第二人民医院血液肿瘤科,河南南阳473000

出　　处：《罕少疾病杂志》2022年第10期90-91,110,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨有核红细胞数在多发性骨髓瘤中的病情诊断与预后预测中的价值。方法2016年2月至2020年10月选择在本院血液科就诊的多发性骨髓瘤患者60例作为MM组,同期选择健康献血员60例作为对照组,检测与判断两组有核红细胞计数阳性率,随访患者预后并进行相关性分析。结果MM组的有核红细胞计数阳性率为18.3%,高于对照组的0.0%(P<0.05)。MM组的白细胞、红细胞、血小板计数与血红蛋白少于对照组(P<0.05),血清IL-4、IL-6、TNF-α含量高于对照组(P<0.05)。在MM组中,随访到2021年1月1日,平均随访时间29.11±4.28个月,死亡19例,死亡率为31.7%;Pearson相关分析显示有核红细胞计数阳性率、白细胞计数、血小板计数、血清IL-6含量与预后死亡存在相关性(P<0.05);单因素与多因素Cox分析显示有核红细胞计数阳性率、白细胞计数、血小板计数、血清IL-6含量都为导致患者预后死亡的重要因素(P<0.05)。ROC曲线显示有核红细胞计数阳性率预测多发性骨髓瘤中预后死亡的曲线下面积为0.81,诊断敏感性为81.5%,特异性为78.2%。结论有核红细胞在多发性骨髓瘤中广泛存在,可导致患者炎症因子与血常规检测异常,也为导致多发性骨髓瘤患者预后死亡的重要因素,也可预测患者的预后死亡。Objective To investigate the values of the nucleated red blood cell count in the diagnosis and prognosis of multiple myeloma.Methods From Februa ry2016 to October 2020,60 cases of patients with multiple myeloma who were treated in the Depa rtment of Hematology of our hospital were selected as the MM group,and 60 cases of healthy blood donors were selected as the control group during the same period.The two groups were detected and judged with positive rates of nucleated red blood cell count,investigated and followed-up the prognosis of patients and given correlation analysis.Results The positive rates of nucleated red blood cell count in the MM group were 18.3%,which were higher than 0.0%in the control group(P<0.05).The white blood cell,red blood cell,platelet count and hemoglobin of the MM group were lower than those of the control group(P<0.05),and the serum levels of IL-4,IL-6,and TNF-αwere higher than those of the control group(P<0.05).In the MM group,the average followed-up time were29.11±4.28 months,19 cases died,and the mortality rate were 31.7%;Pea rson correlation analysis showed the positive rate of nucleated red blood cell count,white blood cell count,platelet count,Serum IL-6 content is correlated with prognostic death(P<0.05);Univa riate and multivariate Cox analysis showed that the positive rate of nucleated red blood cell count,white blood cell count,platelet count,and serum IL-6 content are all leaded to the patient’s prognostic death Important factors(P<0.05).The a rea under the curve of the ROC curve shows that the positive rate of nucleated red blood cell count predicts prognostic death in m ultiple myeloma were 0.81,the diagnostic sensitivity were 81.5%,and the specificity were 78.2%.Conclusion Nucleated red blood cells are widespread in multiple myeloma,which can lead to abnormal inflammatory factors and blood routine tests,and it is also important factor leading to the prognosis and death of multiple myeloma patients,it ca n also predict the prognosis of the patient’s death.

关 键 词：有核红细胞数 多发性骨髓瘤 炎症因子 预后 相关性 

分 类 号：R733.3[医药卫生—肿瘤]