较高危骨髓增生异常综合征伴原始细胞增多患者的中医证候特征及早期死亡危险因素研究  

Analysis of TCM syndrome characteristics and factors associated with early death in higher⁃risk patients with myelodysplastic syndromes with excess blasts

作　　者：张盛琪 蒋佩珍 高琰 刘青果 张朝畅 唐旭东[3] ZHANG Shengqi;JIANG Peizhen;GAO Yan;LIU Qingguo;ZHANG Chaochang;TANG Xudong(Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China;Graduate School of China Academy of Chinese Medical Sciences,Beijing 100700,China;Hematology Department,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中国中医科学院研究生院 [3]中国中医科学院西苑医院血液科

出　　处：《北京中医药大学学报》2024年第3期429-439,共11页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(No.81673819,No.82074258);中国中医科学院科技创新工程重大攻关项目(No.CI2021A01701)。

摘　　要：目的 探讨较高危骨髓增生异常综合征伴原始细胞增多(HR-MDS-EB)患者的中医证候特征及早期死亡危险因素。方法 选取2013年1月—2020年8月中国中医科学院西苑医院血液科病房57例HR-MDS-EB患者的资料,进行回顾性分析。依据生存时间分为早期死亡组与非早期死亡组,收集并分析患者基本信息、临床特征、专科检查、初诊血常规和实验室检查、中医证候特征等资料,筛选死亡危险因素。结果 HR-MDS-EB早期死亡组与非早期死亡组间比较,查尔森合并症指数(CCI)评分、Barthel指数评分、初诊血小板计数、外周血原始细胞比例、乳酸脱氢酶、邪热炽盛证和大便秘的组间差异有统计学意义(P<0.05),根据以上单因素分析结果,提取P<0.05项目进行logistic多因素回归分析,CCI评分对死亡风险的影响有统计学意义(P<0.05)。结论 CCI评分较高是影响HR-MDS-EB患者早期死亡的独立危险因素。Objective We aimed to investigate the TCM syndrome characteristics and risk factors of early death in higher⁃risk patients with myelodysplastic syndromes with excess blasts(HR⁃MDS⁃EB).Methods The data of 57 HR⁃MDS⁃EB patients in the hematology ward of Xiyuan Hospital,China Academy of Chinese Medical Sciences admitted between January 2013 and August 2020 were analyzed.Patients were divided into an early death group and a non⁃early death group according to the survival time.The basic information,clinical characteristics,specialized examination,complete blood cell counts and laboratory examination result for first diagnosis,TCM syndrome characteristics,and other data of patients were collected and analyzed to screen the risk factors of death.Results There were statistically significant differences in Charlson comorbidity index(CCI)score,Barthel index score,platelet count at first diagnosis,blast ratio in peripheral blood,lactate dehydrogenase levels,blazing pathogenic heat pattern,and constipation between the early death group and the non⁃early death group(P<0.05).According to the result of the above univariate analysis,logistic multivariate regression analysis was performed for significant factors P<0.05.CCI score had statistically significant effects on the risk of death(P<0.05).Conclusion Higher CCI score is an independent risk factor for early death in HR⁃MDS⁃EB patients.

关 键 词：骨髓增生异常综合征 死亡危险因素 原始细胞 查尔森合并症指数 中医证候特征 回顾性分析 

分 类 号：R259.513[医药卫生—中西医结合]