| 董海波 谢品浩 袁翠英 张谦 陈兰昕 欧阳建.积分系统参与MDS 诊断的可行性研究[J].,2014,14(32):6303-6306 |
| 积分系统参与MDS 诊断的可行性研究 |
| Scoring SystemInvolved in the Diagnosis of MDS Feasibility Study |
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| DOI： |
| 中文关键词: 积分系统 骨髓增生异常综合征 诊断 |
| 英文关键词: Scoring system Myelodysplastic syndromes (MDS) Diagnosis |
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| 中文摘要: |
| 目的：骨髓增生异常综合征( MDS) 是一种起源于造血干细胞，以高风险向急性髓系白血病转化为特点的难治性血细胞质、
量异常的异质性疾病。对不明原因血细胞减少或者有巨幼红细胞血症的老年人，如果得不到明确的诊断就不会获得有效的治疗。
探讨对伴有不明原因血细胞减少或大红细胞血症患者采用一种积分系统来预测诊断为骨髓增生异常综合征（MDS）的可行性。方
法：应用四个因子即年龄≥ 65，红细胞平均体积（MCV），红细胞分布宽度（RDW），和乳酸脱氢酶（LDH）的一个积分系统来计算诊
断MDS 的概率。结果：调查了303 个病人，他们都因为不明原因的血细胞减少或者大红细胞血症在过去三年（2010～2012）进行
了骨髓检查，最终三分之二患者被诊断为MDS，9％为疑似MDS，采用积分系统前后的MDS诊断率分别为12%和48%。结论：此
四个因子的积分系统可以用于指导MDS患者的诊断。提高MDS的诊断率，减少不必要的骨髓穿刺，减轻病人的疼痛和医疗费用。 |
| 英文摘要: |
| Objective:Myelodysplastic syndromes (MDS) are clonal hematopoietic stem cell disorders primarily seen in the
elderly that are characterized by ineffective hematopoiesis and a propensity to develop AML. Clinicians may be hesitant to refer older
patients with unexplained cytopenias and/or macrocytosis for a bone marrow biopsy (BM), and consequently undiagnosed patients may
be deprived access to effective treatments. To predict the feasibility of myelodysplastic syndromes (MDS) by using a scoring system for
diagnosing patients with unknown cause cells to reduce or bright red cell anemia.Methods:We described 4 factors which were aged over
65, mean cell volume (MCV), red cell distribution width (RDW), and lactate dehydrogenase (LDH) respectively and suggested a scoring
systemto calculate the post-test diagnostic probability of MDS.Results:Validated this scoring systemin a cohort of 303 individuals who
underwent bone marrow examinations for the investigation of unexplained cytopenias and or macrocytosis over a 3-year period at our
institution (2010-2012). Thirty-two percent of the patients were diagnosed with MDS and 9% had suspected MDS. The post-test
likelihood of a diagnosis of MDS increased from 12% when none of the four identified factors were 48% when 3 or more factors were
present.Conclusion:This scoring system can be used to guide the diagnostic testing of patients presenting with unexplained cytopenias
or macrocytosis. This scoring systemcan improve the diagnosis of MDS and reduce unnecessary bone marrow puncture and ease the pain
of patients and medical costs. |
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