MDS患者血清LDH、铁蛋白水平的动态变化及与预后的关系  

Dynamic Changes of Serum LDH and Ferritin Levels in MDS Patients and Their Relationship with Prognosis

作　　者：李芬 冯晓丽[1] 韩春韬 LI Fen;FENG Xiaoli;HAN Chuntao(Department of Laboratory Medicine,Anyang Traditional Chinese Medicine Hospital,Anyang Henan 455000,China)

机构地区：[1]安阳市中医院检验科,河南安阳455000

出　　处：《临床研究》2025年第1期110-113,共4页Clinical Research

摘　　要：目的探讨骨髓增生异常综合征(MDS)患者血清乳酸脱氢酶(LDH)、铁蛋白(SF)水平的动态变化及与预后的关系。方法选取安阳市中医院2020年1月至2023年2月收治的60例MDS患者为观察组,按照世界卫生组织(WHO)标准的分型分为MDS伴环形铁粒幼细胞和单系发育异常(MDS-RS-SLD)1例,MDS伴单系发育异常(MDS-SLD)8例,MDS伴多系发育异常(MDS-MLD)26例,MDS伴原始细胞增多-1(MDS-EB-1)11例,MDS伴原始细胞增多-2(MDS-EB-2)14例,另选取同期在本院体检正常者58例为对照组。比较观察组和对照组的患者血清LDH、SF、β_(2)微球蛋白(β_(2)-MG)、维生素B_(12)(VitB_(12))水平及辅助性T细胞17(Th17)水平,比较MDS不同分型患者不同预后分级的差异,对影响患者死亡的因素进行单因素及多因素Cox回归分析。结果观察组的血清LDH、SF、β_(2)-MG、Th17、VitB_(12)水平显著高于对照组,差异均有统计学意义(P<0.05)。MDS不同分型中,预后低危的有27例(45.00%),预后中危的有21例(35.00%),预后高危的有12例(20.00%),MDS-EB-2型预后高危率大于MDS-MLD型,差异均有统计学意义(P<0.05)。单因素分析及Cox回归模型结果显示,年龄、国际预后积分系统(IPSS分级)、SF、Th17、MDS不同分型是影响患者生存预后的影响因素,差异均有统计学意义(P<0.05)。结论MDS患者的血清LDH、SF、β_(2)-MG、VitB_(12)、Th17水平显著升高,年龄、IPSS分级、SF、Th17、MDS不同分型是影响患者死亡预后的影响因素,可作为评估患者预后的参考指标。Objective To investigate the dynamic changes of serum lactate dehydrogenase(LDH)and ferritin(SF)levels in patients with myelodysplastic syndromes(MDS)and their relationship with prognosis.Methods A total of 60 MDS patients admitted to Anyang Traditional Chinese Medicine Hospital from January 2020 to February 2023 were selected as the observation group.According to the World Health Organization(WHO)classification,they were MDS with ringed sideroblasts and single lineage dysplasia(MDS-RS-SLD)in 1 case,single lineage dysplasia(MDS-SLD)in 8 cases,multi-lineage dysplasia(MDS-MLD)in 26 cases,excess blasts-1(MDS-EB-1)in 11 cases,and excess blasts-2(MDS-EB-2)in 14 cases.An additional 58 normal individuals during the same period were selected as the control group.Serum levels of LDH,SF,β_(2)-microglobulin(β_(2)-MG),vitamin B_(12)(VitB_(12)),and helper T cell 17(Th17)were compared between the two groups,as well as differences in prognosis grading among various MDS subtypes.Univariate and multivariate Cox regression analyses were performed to examine factors affecting patient mortality.Results Serum levels of LDH,SF,β_(2)-MG,Th17,and VitB_(12) in the observation group were significantly higher than those in the control group(P<0.05).Among the different MDS subtypes,there were 27 cases(45.00%)classified as low-risk,21 cases(35.00%)as intermediate-risk,and 12 cases(20.00%)as high-risk.The high-risk rate for MDS-EB-2 was greater than that for MDS-MLD,with statistically significant differences(P<0.05).Univariate analysis and results from the Cox regression model indicated that age,International Prognostic Scoring System(IPSS)grading,SF,Th17,and different MDS subtypes were significant factors influencing patient survival prognosis(P<0.05).Conclusion Serum levels of LDH,SF,β_(2)-MG,VitB_(12),and Th17 are significantly elevated in MDS patients.Age,IPSS grading,SF,Th17 levels,and different MDS subtypes are important factors affecting mortality prognosis,which can serve as reference indicators for evaluating patient prognosis.

关 键 词：骨髓增生异常综合征 血清乳酸脱氢酶 铁蛋白 预后 

分 类 号：R725.5[医药卫生—儿科]