RDW-SD、NLR及FIB与多发性骨髓瘤患者预后的关系及预测价值  

The relationship of RDW-SD,NLR and FIB with the prognosis of multiple myeloma patients and their predictive value

作　　者：黄倩[1] 杨春燕[1] 王海燕[1] 黄玉[1] 程盼盼[1] 张颢[1] Huang Qian;Yang Chunyan;Wang Haiyan;Huang Yu;Cheng Panpan;Zhang Hao(Department of Hematology,Affiliated Hospital of Jining Medical University,Jining 272029 China)

机构地区：[1]济宁医学院附属医院血液科,济宁272029

出　　处：《中国医师杂志》2023年第1期76-80,共5页Journal of Chinese Physician

摘　　要：目的探讨红细胞分布宽度标准差(RDW-SD)、中性粒细胞/淋巴细胞值(NLR)及纤维蛋白原(FIB)与多发性骨髓瘤(MM)患者预后的关系及预测价值。方法本研究采用回顾性研究方法,选取2017年1月至2019年10月济宁医学院附属医院血液科收治的120例MM初诊患者,随访时间为24个月,其中存活62例(生存组)、死亡58例(死亡组),对比两组患者的RDW-SD、NLR及FIB值,采用受试者工作特征(ROC)曲线分析三项指标单独及联合应用时预测MM患者随访结局的价值,采用logistic回归模型分析影响MM患者预后的相关因素。结果120例初治MM患者中,生存组患者的RDW-SD、NLR、FIB测定值均显著低于死亡组患者,差异有统计学意义(均P<0.05);RDW-SD+NLR+FIB预测MM患者不良结局的灵敏度为88.96%、特异度为84.50%、ROC曲线下面积(AUC)为0.919;logistic多因素回归分析结果显示MM患者年龄≥60岁、国际分期体系(ISS)分期为Ⅲ期、β2-MG≥3500 ng/ml、RDW-SD升高、NLR增大、FIB升高会增大MM患者不良预后的风险(均P<0.05)。结论初治MM患者的RDW-SD、NLR、FIB三项指标与患者不良预后结局具有较为密切的关系,联合应用对于预测患者预后结局具有一定的价值。Objective To explore the relationship between the standard deviation of red blood cell distribution width(RDW-SD),neutrophil/lymphocyte value(NLR),fibrinogen(FIB)and the prognosis of multiple myeloma(MM)patients and their predictive value.Methods In this study,a retrospective study method was used to select 120 patients with MM who were initially diagnosed in the department of hematology of the Affiliated Hospital of Jining Medical College from January 2017 to October 2019.The follow-up time was 24 months,including 62 patients who survived(survival group)and 58 patients who died(death group).The RDW-SD,NLR and FIB values of the two groups were compared,and the value of the three indicators in predicting the follow-up outcome of MM patients was analyzed using the receiver operating characteristic(ROC)curve.Logistic regression model was used to analyze the related factors affecting the prognosis of MM patients.Results Among 120 newly treated MM patients,the RDW-SD,NLR and FIB of the survival group were significantly lower than those of the death group(all P<0.05);The sensitivity,specificity and area under ROC curve(AUC)of RDW-SD+NLR+FIB in predicting adverse outcomes of MM patients were 88.96%,84.50%and 0.919 respectively.Logistic multivariate regression analysis showed that≥60 years old,International Staging System(ISS)Ⅲ,β2-microglobulin(β2-MG)≥3500 ng/ml,increased RDW-SD,NLR,and FIB will increase the risk of poor prognosis in MM patients(all P<0.05).Conclusions The RDW-SD,NLR and FIB have a close relationship with the poor prognosis of newly treated MM patients,and the combined application has certain value in predicting the prognosis of patients.

关 键 词：多发性骨髓瘤 红细胞分布宽度 中性粒细胞 淋巴细胞 纤维蛋白原 

分 类 号：R733.3[医药卫生—肿瘤]