控制营养状况、预后营养指数对骨髓增生异常综合征患者预后分析  

Prognostic analysis of controlling nutritional status and prognostic nutritional index in patients with myelo⁃dysplastic syndromes

作　　者：张权娥 陈秋妮 陈月[1,2] 张丽娟[1,2] 马晶晶[1,2] 张欣[1,2] 陈侃侃[1,2] 王春玲[1,2] 何正梅[1,2] ZHANG Quan′e;CHEN Qiuni;CHEN Yue;ZHANG Lijuan;MA Jingjing;ZHANG Xin;CHEN Kankan;WANG Chunling;HE Zhengmei(Department of Hematology,the Affiliated Huai′an No.1 People′s Hospital of Nanjing Medical University,Huai′an 223300,China;Key Laboratory of Hematology of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属淮安第一医院血液科,江苏淮安223300 [2]南京医科大学血液病重点实验室,南京210029

出　　处：《实用医学杂志》2023年第17期2204-2209,共6页The Journal of Practical Medicine

基　　金：江苏省卫生健康委科研项目(编号:H2019082);淮安市科技局支撑项目(编号:HAB202020)。

摘　　要：目的探讨控制营养状况、预后营养指数(PNI)对骨髓增生异常综合征患者预后作用。方法回顾性分析119例骨髓增生异常综合征患者的临床资料,根据受试者工作特征曲线(ROC)计算出观察指标的最佳cut-off值,CONUT评分、PNI分别以4、36.75分界值进行分组,分析各组年龄、性别、血细胞计数、IPSS分组等临床特征及通过单因素和多因素分析其对MDS预后价值。结果单因素分析结果显示年龄、血小板计数、骨髓原始细胞计数、IPSS评分、CONUT评分是影响MDS患者OS的危险因素;多因素分析显示,骨髓原始细胞数(HR=1.06,95%CI:1.01~1.12,P=0.028)、CONUT评分(HR=0.606,95%CI:0.39~0.95,P=0.028)是影响MDS患者的OS独立危险因素。结论初诊MDS患者CONUT评分高提示预后不良,是影响MDS预后的独立危险因素,而PNI不是MDS预后的独立危险因素。Objective To explore the impact of controlling nutritional status and prognostic nutritional index on the prognosis of patients with myelodysplastic syndrome.Methods The clinical data of 119 patients with myelodysplastic syndrome treated in the department of Hematology of our hospital from March 2010 to December 2020 were retrospectively analyzed.The optimal cut-off point of observation index was calculated according to the receiver operating characteristic curve(ROC).CONUT score and PNI were grouped based on the cut-off points of 4 and 36.75,respectively,and the differences between age,gender,blood cell count and IPSS scores were analyzed.The prognostic factors were analyzed via univariate and Cox multivariate regression analyses.Results The univari⁃ate analysis revealed that age,platelet count,bone marrow blast cell count,IPSS scores and CONUT were risk fac⁃tors for the prognosis of patients with MDS.The multivariate analysis revealed that bone marrow blast cell count(HR=1.06,95%CI:1.01~1.12,P=0.028)and CONUT(HR=0.606,95%CI:0.39~0.95,P=0.028)were independent prognosis risk factors of patients with MDS.Conclusions High CONUT score in newly diagnosed MDS patients indicates poor prognosis and is an independent risk factor for MDS prognosis,while PNI is not an independent risk factor for MDS prognosis.

关 键 词：骨髓增生异常综合征 控制营养状况 预后营养指数 预后 

分 类 号：R551[医药卫生—血液循环系统疾病]