| 黄伟波,李宝静,姚海英,等.外周血单核细胞绝对值对多发性骨髓瘤病人预后的预测价值[J].安徽医药,2025,29(8):1583-1587. |
| 外周血单核细胞绝对值对多发性骨髓瘤病人预后的预测价值 |
| Predictive value of absolute monocyte count for prognosis in patients with multiple myeloma |
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| DOI：10.3969/j.issn.1009-6469.2025.08.019 |
| 中文关键词: 多发性骨髓瘤 单核细胞 预后 分期 白蛋白 乳酸脱氢酶 |
| 英文关键词: Multiple myeloma Monocytes Prognosis By stages Albumin Lactate dehydrogenase |
| 基金项目:保定市科技计划项目( 2341ZF094) |
| 作者 | 单位 | | 黄伟波 | 保定市第一中心医院, 血液科,河北保定,071000 | | 李宝静 | 保定市第一中心医院,质控科,河北保定,071000 | | 姚海英 | 保定市第一中心医院, 血液科,河北保定,071000 | | 李明炜 | 保定市第一中心医院, 血液科,河北保定,071000 | | 高婷婷 | 保定市第一中心医院, 血液科,河北保定,071000 | | 王欢 | 保定市第一中心医院, 血液科,河北保定,071000 | | 郝佳蕾 | 保定市第一中心医院, 血液科,河北保定,071000 | | 李梦亚 | 保定市第一中心医院, 血液科,河北保定,071000 |
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| 中文摘要: |
| 目的探讨外周血单核细胞绝对值(AMC)对多发性骨髓瘤( MM)病人预后的预测价值。方法回顾性选取保定市第一中心医院于 2015年 1月至 2020年 6月收治的 80例初诊 MM病人为研究对象。全自动血细胞分析仪检测病人入院时 AMC，并根据 AMC水平将 80例病人分为 AMC减低组( n=7)、 AMC正常组( n=54)和 AMC升高组( n=19)。另外根据病人 3年内生存情况分为生存组( n=62)和死亡组( n=18)。多因素 Cox回归模型分析 MM病人预后的影响因素； Kaplan-Meier法绘制不同 AMC水平病人的生存曲线；受试者操作特征曲线( ROC曲线)分析外周血 AMC对 MM病人预后的预测价值。结果 AMC减低组、 AMC正常组和 AMC升高组白蛋白、血红蛋白和 LDH水平比较差异有统计学意义(P<0.05)；生存组和死亡组国际分期系统( ISS)分期、 Du-rie-Salmon(DS)分期、白蛋白、乳酸脱氢酶(LDH)比较差异有统计学意义(P<0.05)且死亡组 AMC高于生存组［(0.83±0.23)×109/L比( 0.48±0.17)×109/L］(P<0.05)；多因素 Cox回归分析结果显示， ISS分期、 DS分期、L，DH和 AMC水平是 MM病人预后的独立危险因素( HR=1.74、1.96、1.50、1.41，P<0.05)，白蛋白水平是 MM病人预后的保护因素( HR=0.76，P<0.05)； AMC正常组 3年生存率高于 AMC升高组高于 AMC减低组( log-rank χ2=10.76，P<0.05)；外周血 AMC预测 MM病人预后的曲线下面积( AUC)为 0.90， 95%CI:(0.82，0.96)，灵敏度为 83.30%，特异度为 90.32%。结论外周血 AMC是 MM病人预后的影响因素，且对 MM预后具有较高预测价值。 |
| 英文摘要: |
| Objective To evaluate the predictive value of absolute monocyte count (AMC) for prognosis in patients with multiple my-eloma (MM).Methods This retrospective study included 80 newly diagnosed MM patients admitted to Baoding First Central Hospitalfrom January 2015 to June 2020. AMC was measured at admission using an automated hematology analyzer. Patients were stratified in-to three groups by AMC levels: AMC-reduced (n=7), AMC-normal (n=54), and AMC-elevated (n=19). Based on 3-year survival out-comes, patients were categorized into survival (n=62) and death (n=18) groups. Multivariate Cox regression analyzed prognostic factors,Kaplan-Meier analysis compared survival curves across AMC groups, and receiver operating characteristic curves (ROC) assessedAMC's predictive performance.Results Significant differences in albumin (Alb), hemoglobin (Hb), and lactate dehydrogenase (LDH) levels were observed among AMC-reduced, AMC-normal, and AMC-elevated groups (P<0.05). International Staging System (ISS) stage, DS stage, Alb, and LDH differed significantly between survival and death groups (P<0.05). AMC was higher in the death group (0.83 ± 0.23) ×10./L than in the survival group (0.48 ± 0.17) ×10./L (P<0.05). Multivariate Cox regression identified ISS stage (HR =1.74), DS stage (HR=1.96), LDH (HR = 1.50), and AMC (HR =1.41) as independent risk factors (P<0.05), while Alb was a protective factor for the prognosis of MM patients (HR =0.76, P< 0.05). The AMC-normal group exhibited a higher 3-year survival rate than the AMC-elevated group (log-rank=10.76, P< 0.05). ROC analysis demonstrated AMC's prognostic predictive value with an AUC of 0.90,95% CI:(0.82, 0.96), sensitivity of 83.30%, and specificity of 90.32%.Conclusion Peripheral blood AMC is a prognostic factor for MM patients and has high predictive value for MM prognosis. |
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