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目的:研究骨髓增生异常综合征(MDS)患者平均红细胞体积(MCV)、血清乳酸脱氢酶(LDH)、β2-微球蛋白(β2-MG)、铁蛋白(SF)、VitB12等实验室指标与疾病预后的相关性。方法:分析148例MDS患者初诊时MCV、LDH、β2-MG、SF、VitB12等实验室指标与生存期的关系。结果:148例MDS患者死亡72例(48.6%),失访17例(11.5%),中位生存期为20.0(2.3～72.6)个月。初诊血清LDH水平为(363.73±388.14)U/L,LDH升高组91例,中位生存期为23.3个月,正常组57例(63.5个月),明显缩短,差异有统计学意义(P<0.05)。血清β2-MG水平为(3.02±1.90)mg/L,β2-MG增高组108例,中位生存期为20.1个月,较正常组(40例,67.5个月)明显缩短(P<0.05)。血清SF水平为(600.44±482.73)μg/L,SF增高组95例,MDS患者中位生存期为12.4个月,较正常组(53例,32.8个月)明显缩短(P<0.05)。外周血MCV、VitB12等指标增高组与正常组中位生存期比较,差异无统计学意义(P>0.05)。将性别、年龄与LDH、β2-MG、SF实验室指标进行COX多因素模型分析,得出SF升高是MDS预后的独立危险因素。结论:MDS患者血清LDH、β2-MG、SF指标与疾病的进展及预后相关,监测上述指标对MDS患者预后判断具有一定的提示性。
OBJECTIVE: To study the changes of mean corpuscular volume (MCV), serum lactate dehydrogenase (LDH), β2-microglobulin (β2-MG), ferritin (SF) and VitB12 in patients with myelodysplastic syndrome Correlation with disease prognosis. Methods: The relationship between laboratory markers and survival of MCV, LDH, β2-MG, SF and VitB12 in 148 patients with MDS was analyzed. Results: Among 148 MDS patients, 72 (48.6%) died and 17 (11.5%) lost the follow-up. The median survival time was 20.0 (2.3-72.6) months. The initial serum LDH level was (363.73 ± 388.14) U / L, 91 cases had elevated LDH, the median survival time was 23.3 months, and 57 cases (63.5 months) in normal group were significantly shorter (P <0.05). Serum β2-MG level was (3.02 ± 1.90) mg / L in 108 patients with elevated β2-MG, the median survival time was 20.1 months, significantly shorter than that in the normal group (40, 67.5 months) . The serum SF level was (600.44 ± 482.73) μg / L, SF was increased in 95 cases, and the median survival time in MDS patients was 12.4 months, which was significantly shorter than that in the normal group (53.82.8 months) (P <0.05). The median survival time of peripheral blood MCV, VitB12 and other indicators increased compared with the normal group, the difference was not statistically significant (P> 0.05). By sex, age and LDH, β2-MG, SF laboratory indicators COX multivariate model analysis, drawn SF elevation is an independent risk factor for MDS prognosis. Conclusion: The serum LDH, β2-MG and SF indexes of MDS patients are related to the progress and prognosis of the disease. It is suggested that the above indexes can be used to predict the prognosis of MDS patients.