文章摘要
尚碧莲,王厚照,陈涌泉,郭春华,沈松坤.有核红细胞数在白血病患者危险度分层评估中的意义[J].,2020,(19):3687-3690
有核红细胞数在白血病患者危险度分层评估中的意义
Significance of Nucleated Red Blood Cell Count of in the Risk Stratified Assessment of Leukemia Patients
投稿时间:2019-12-30  修订日期:2020-01-27
DOI:10.13241/j.cnki.pmb.2020.19.017
中文关键词: 有核红细胞数  急性髓系白血病  危险度分层  外周血原始细胞
英文关键词: Nucleated red blood cell count  Acute myeloid leukemia  Risk stratification  Peripheral blood blast
基金项目:国家自然科学基金项目(81272246)
作者单位E-mail
尚碧莲 厦门大学附属成功医院(中国人民解放军陆军第七十三集团军医院)检验科 福建 厦门 361003 shangbilian1977@163.com 
王厚照 厦门大学附属成功医院(中国人民解放军陆军第七十三集团军医院)检验科 福建 厦门 361003  
陈涌泉 厦门弘爱医院检验科 福建 厦门 361009  
郭春华 厦门大学附属成功医院(中国人民解放军陆军第七十三集团军医院)血液科 福建 厦门 361003  
沈松坤 厦门大学附属成功医院(中国人民解放军陆军第七十三集团军医院)检验科 福建 厦门 361003  
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中文摘要:
      摘要 目的:探讨有核红细胞数(nucleated red blood cell count,NRBCs)在白血病患者危险度分层评估中的意义。方法:选择2016年2月到2019年7月在厦门大学附属成功医院(本院)诊治的急性髓系白血病(Acute myeloid leukemia,AML)患者120例,检测其NRBCs并进行危险度分层,回顾分析患者的临床资料并与其NRBCs进行相关性分析。结果:120例患者中,危险度分层为低危40例,中危60例,高危20例。低危组和中高危组的患者年龄、性别、核仁磷酸蛋白(nucleophosmin,NPM1)突变、骨髓原始细胞等对比差异无统计学意义(P>0.05),其外周血原始细胞、FMS 样酪氨酸激酶-3(FMS-like tyrosinekinase 3,FLT3)突变、急性生理和慢性健康状况Ⅱ(acute physiology andchron ic health evaluationⅡ,APACHEⅡ)评分、白细胞(white blood cell,WBC)、血红蛋白(hemoglobin,Hb)、血小板(platelet,PLT) 、白蛋白(albumin,ALB)与丙氨酸氨基转移酶(alanine aminotransferase,ALT)值等对比差异有统计学意义(P<0.05)。低危组的NRBCs为3.94±0.29个,显著低于中高危组(11.87±2.11个,P=0.000)。Pearson相关分析显示危险度分层与NRBCs、外周血原始细胞、APACHEⅡ评分、FLT3突变、PLT有显著相关性(r=0.823、0.566、0.494、0.578、0.781,P<0.05)。logistic回归分析显示NRBCs、外周血原始细胞、APACHEⅡ评分、FLT3突变、PLT为影响急性髓系白血病患者危险度分层的主要因素(P<0.05)。结论:不同危险度分层的白血病患者的NRBCs具有显著差异,其与患者的病理特征显著相关,也是影响患者危险度分层的主要因素。
英文摘要:
      ABSTRACT Objective: To investigate the significance of stratified assessment of risk of nucleated red blood cell count (NRBCs) in leukemia patients. Methods: 120 patients with acute myeloid leukemia (AML) were enrolled in our hospital from February 2016 to July 2019, their NRBCs were detected and risk stratification were performed, and patients were retrospectively analyzed clinical data and correlation analysis with its NRBCs. Results: Among the 120 patients, the risk stratification were 40 patients at low-risk, 60 patients at intermediate-risk, and 20 patients at high-risk. There were no significant differences in age, gender, NPM1 mutation and bone marrow blasts compared between in the low-risk group and middle-high-risk group(P>0.05). Peripheral blood blasts, FLT3 mutation, APACHE II score, WBC, Hb, PLT, ALB and ALT values in the low-risk group and middle-high-risk group compared difference were statistically significant (P<0.05). The NRBCs in the low-risk group were 3.94±0.29, which was significantly lower than that in the medium-high-risk group (11.87±2.11, P=0.000). Pearson correlation analysis showed that risk stratification were significantly correlated with NRBCs, peripheral blood blasts, APACHE II score, FLT3 mutation, and PLT(r=0.823, 0.566, 0.494, 0.578, 0.781, P<0.05). Logistic regression analysis showed that NRBCs, peripheral blood blasts, APACHE II score, FLT3 mutation and PLT were the main factors affecting the risk stratification of patients with acute myeloid leukemia (P<0.05). Conclusion: There are significant differences in NRBCs between leukemia patients with different risk stratification, which are significantly related to the pathological characteristics of patients, and is also the main factor affecting the risk stratification of patients.
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