摘要
目的:探讨中性白细胞/淋巴细胞(NLR)比例和血小板/淋巴细胞比例(PLR)变化在多发性骨髓瘤(MM)患者中的意义。方法:收集2007年8月至2010年8月本院收治的多发性骨髓瘤患者80例,记录并分析患者的临床资料,包括血红蛋白(Hb)、平均红细胞体积(MCV)、红细胞平均血红蛋白量(MCH)、平均红细胞血红蛋白浓度(MCHC)、红细胞分布宽度(RDW)、白细胞计数(WBC)、中性粒细胞绝对数(ANC)、血小板数目(PC)、肾小球滤过率(GFR)、血钙、白蛋白、β2微球蛋白等。结果:ROC曲线分析预测预后的NLR最佳阈值为2.78(敏感性为83.3%,特异性为43.1%),PLR最佳阈值为155.58(敏感性为67.7%,特异性为36.9%)。依据不同NLR和PLR值将所有患者进行分组,高NLR和PLR患者白蛋白水平较低,临床分期较高。高NLR患者以男性为主,血红蛋白、GFR值、白蛋白水平较低,白细胞数目和β2微球蛋白水平较高。高PLR患者白蛋白水平较低,临床分期较高。多因素分析显示,β2微球蛋白水平和NLR是影响多发性骨髓瘤患者预后的因素(P<0.05)。Kaplan-Meier生存分析显示,高NLR患者生存期中位数为37个月(95%CI:21.80-52.19),低NLR患者生存期中位数为66个月(95%CI:53.19-78.80)。在高PLR患者中,生存期中位数为45个月(95%CI:0.00-91.18),低PLR患者生存期中位数为62个月(95%CI:45.67-78.33)。结论:高NLR值(>2.78)与MM患者预后差相关,可作为MM患者预后的独立预测因素之一。
Objective:To investigate the significance of neutrophil /lymphocyte ratio( NLR) and platelet /lymphocyte ratio( PLR) in patients with multiple myeloma ( MM).Methods:Eighty patients with multiple myeloma admitted in our hospital from August 2007 to August 2010 were selected.The clinical data of the patients,including hemoglobin ( Hb), mean corpus-cular volume ( MCV),mean corpuscular hemoglobin ( MCH),mean corpuscular hemoglobin concentration ( MCHC),red blood cell distribution width ( RDW),white blood cell ( WBC ) count,absolute neutrophil count ( ANC),platelet count ( PC),glomerular filtration rate ( GFR),calcium,albumin,β2 microglobulin and so on were collected and analyzed.Results:The optimal threshold of NLR was 2.78 ( sensitivity:83.3%,specificity:43.1%). The optimal threshold of PLR was 155.58 ( sensitivity:67.7%,specificity:36.9%).All patients were grouped according to NLR and PLR values,patients with high NLR and PLR had lower albumin levels and higher clinical stages. High NLR patients were mainly men,hemoglobin,GFR values,albumin levels were lower,and the white blood cells count and β2 microglobulin level were higher.High PLR patients showed low albumin level and higher clinical stage. Multivariate analysis showed that β2 microglobulin and NLR were prognostic factors in patients with multiple myeloma ( P < 0.05).Kaplan-Meier survival analysis showed that the median survival time was 37 months ( 95% CI:21.80 - 52.19) for patients with high NLR and 66 months ( 95% CI:53.19 - 78.80) for patients with low NLR.The median survival time was 45 months ( 95% CI:0.00 to 91.18) in patients with high PLR and 62 months ( 95% CI:45.67 - 78.33) in patients with low PLR.Conclusion:High NLR (> 2.78) associates with poor prognosis in patients with MM,and it may be considered as an independent prognostic factor for MM patients.
作者
孙巨勇
牟娜
牟佳
张长庚
王冬梅
SUN Ju-Yong;MU Na;MU Jia;ZHANG Chang-Geng;WANG Dong-Mei(Department of Clinical Laboratorial Examination,Harrison International Peace Hospital,Hengshui 053000,Hebei Province,China;Department of Clinical Laboratorial Examination,Hengshui Maternal and Child Health Hospital,Hengshui 053000,Hebei Province,China;Department of Hematology,Harrison International Peace Hospital,Hengshui 053000,Hebei Province,China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2019年第4期1185-1189,共5页
Journal of Experimental Hematology
