血细胞相关比值与多发性骨髓瘤患者临床预后的相关性  

Correlation between correlation ratio of blood cells and clinical prognosis of patients with multiple myeloma

作　　者：余超[1] 吴玉玲[1] 张手丽 李江[3] 汪勇[1] 曹慧 YU Chao;WU Yuling;ZHANG Shouli;LI Jiang;WANG Yong;CAO Hui(Department of Hematology,Huangshan City People's Hospital,Huangshan,245000,China;Department of Blood Laboratory,Huangshan City People's Hospital;Department of Infection,the First Affiliated Hospital of Anhui Medical University)

机构地区：[1]黄山市人民医院血液科,安徽黄山245000 [2]黄山市人民医院血液实验室 [3]安徽医科大学第一附属医院感染科

出　　处：《临床血液学杂志》2023年第4期249-254,共6页Journal of Clinical Hematology

摘　　要：目的:分析外周血血细胞中的中性粒细胞/淋巴细胞比值(NLR)、单核细胞/淋巴细胞比值(MLR)与多发性骨髓瘤(MM)患者临床预后的关系。方法:纳入2015年6月至2020年6月收治的85例MM患者为研究对象,患者入院后均接受化疗,自治疗开始随访2年,最后74例患者完成全过程。根据随访期间生存情况分为病死组(18例)与生存组(56例),比较2组一般资料、NLR、MLR与其他实验室指标,重点分析入院时NLR、MLR与患者临床预后的关系。结果:74例患者生存时间7~24个月,中位生存时间24.00(23.75,24.00)个月。随访期间,18例患者死亡,占24.32%;病死组疾病ISS分期较生存组高,差异有统计学意义(P<0.05);病死组入院时及首次疗效评估时NLR、MLR均较生存组高(P<0.05);生存组首次疗效评估时NLR、MLR值显著低于入院时(P<0.05);但病死组首次疗效评估时NLR、MLR值与入院时比较,差异无统计学意义(P>0.05);病死组入院时红细胞计数(RBC)、β2-微球蛋白(β2-MG)、乳酸脱氢酶(LDH)、钙较生存组高,血红蛋白(Hb)、白蛋白(ALB)较生存组低,差异有统计学意义(P<0.05);Cox回归分析显示,入院时NLR、MLR高表达是MM患者病死的独立危险因素(P<0.05);ROC曲线显示,入院时RBC、钙预测MM患者临床预后的价值较低,入院时NLR、MLR、Hb、ALB、β2-MG、LDH对MM患者临床预后均有一定预测价值,且入院时NLR、MLR预测价值相对更高。结论:NLR、MLR与MM患者临床预后有关,可能是患者病死的独立危险因素,可作为患者临床预后的早期预测指标。Objective To analyze the relationship between neutrophil/lymphocyte ratio(NLR),monocyte/lymphocyte ratio(MLR)in peripheral blood cells and the clinical prognosis of patients with multiple myeloma(MM).Methods A total of 85 MM patients admitted to the hospital from June 2015 to June 2020 were included in the study.All patients received chemotherapy after admission.They were followed up for 2 years from the beginning of treatment.They were divided into death group(18 patients)and survival group(56 patients)according to their survival during the follow-up period.The general data,NLR,MLR and other laboratory indicators of the two groups were compared,and the relationship between NLR,MLR and the clinical prognosis of the patients was analyzed.Results A total of 74 patients completed the whole process of the study.The survival time was 7-24 months,and the median survival time was 24.00(23.75,24.00)months.During the follow-up period,18 patients died,accounting for 24.32%.The ISS stage of disease in death group was higher than that in survival group,with statistical significant differences(P<0.05).The NLR and MLR of the death group were higher than those of the survival group at admission and at the first evaluation of efficacy(P<0.05).The NLR and MLR values in the survival group at the first efficacy evaluation were significantly lower than those at admission(P<0.05).However,there was no statistical significant difference in NLR and MLR values between the death group and the admission group(P>0.05).The red blood cell count(RBC),β2-microglobulin(β2-MG),lactate dehydrogenase(LDH)and calcium in the death group were higher than those in the survival group,and hemoglobin(Hb)and albumin(ALB)were lower than those in the survival group,with statistical significant differences(P<0.05).Cox regression analysis showed that high expression of NLR and MLR on admission were independent risk factors for death in MM patients(P<0.05).ROC curve showed that RBC and calcium at admission had low value in predicting the clinical prognosis of

关 键 词：多发性骨髓瘤 中性粒细胞/淋巴细胞比值 单核细胞/淋巴细胞比值 预后 相关性 

分 类 号：R733.3[医药卫生—肿瘤]