| 余浩源,孙静雅,汪笑寒,等.血小板与淋巴细胞比值、乳酸脱氢酶对初诊骨髓增生异常综合征病人预后的价值研究[J].安徽医药,2026,30(1):96-102. |
| 血小板与淋巴细胞比值、乳酸脱氢酶对初诊骨髓增生异常综合征病人预后的价值研究 |
| The prognostic value of platelet-to-lymphocyte ratio and lactate dehydrogenase in patients with newly diagnosed myelodysplastic syndromes |
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| DOI：10.3969/j.issn.1009-6469.2026.01.020 |
| 中文关键词: 骨髓增生异常综合征 血小板 /淋巴细胞 乳酸脱氢酶 修订后国际预后积分系统(IPSS-R) 预后 |
| 英文关键词: Myelodysplastic syndrome Platelet-to-lymphocyte ratio Lactate dehydrogenase Revised international prognostic scoring system(IPSS-R) Prognosis |
| 基金项目:国家自然科学基金资助项目( 81800124)；江苏省卫健委面上科研项目( H201629) |
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| 中文摘要: |
| 目的探讨血小板与淋巴细胞比值( PLR)、乳酸脱氢酶( LDH)在初诊骨髓增生异常综合征( MDS)病人中的预后价值。方法回顾性分析 2016年 1月至 2022年 5月就诊于徐州医科大学附属医院的 146例初诊 MDS病人，通过受试者操作特征曲线(ROC曲线)将其分为高 PLR组( PLR>55.73)和低 PLR组( PLR≤55.73)并应用统计学方法分析不同因素对病人总生存期( OS)的影响，以及不同治疗方案对病人预后的影响。结果高 PLR组病人的，OS较低 PLR组明显缩短( P=0.003)高 LDH组病人的 OS较低 LDH组明显缩短( P=0.009)。多因素分析提示，初诊时较低的血小板计数( <100×109/L)、较低的淋巴细，胞计数( <1.2× 109/L)、较高的乳酸脱氢酶水平( ≥250 U/L)、较高的修订后国际预后积分系统( IPSS-R)评分( >4.5分)和较高的 PLR水平( >55.73)是初诊 MDS病人 OS的独立不良预后因素。将病人按治疗方案的不同分为去甲基化组和非去甲基化组，结果显示接受去甲基化治疗后获得缓解［完全缓解 +部分缓解 +骨髓完全缓解］的病人数达总缓解人数的 70.2%(40/57)，远高于接受非去甲基化治疗后获得缓解的人数比例 29.8%(17/57)尤其在高 PLR组病人中应用去甲基化方案治疗获得缓解的病人数 76.5%(13/ 17)显著多于应用非去甲基化方案治疗获得缓病人数 23.5%(4/17)。结论 PLR及 LDH水平可辅助 IPSS-R作为评估初诊 解的，MDS病人病情及治疗效果的评价指标。 |
| 英文摘要: |
| Objective To investigate the prognostic value of platelet-to-lymphocyte ratio (PLR) and lactate dehydrogenase (LDH) in patients with newly diagnosed myelodysplastic syndromes (MDS).Methods One hundred and forty-six patients with newly diagnosedMDS who were admitted The Affiliated Hospital of Xuzhou Medical University from January 2016 to May 2022 were retrospectivelyanalyzed. They were divided into a high PLR group (PLR>55.73) and a low PLR group (PLR≤55.73), and statistical methods were ap-plied to analyse the effects of different factors on patients' overall survival (OS) and the effects of different treatment plans on patients'prognosis.Results Patients in the high PLR group had significantly shorter OS than those in the low PLR group (P=0.003), and pa-tients in the high LDH group had significantly shorter OS than those in the low LDH group (P=0.009). Multifactorial analysis suggest-ed that lower platelet count (<100×109/L), lower lymphocyte count (<1.2×109/L), higher lactate dehydrogenase level (≥250 U/L), higher revised international prognostic scoring system (IPSS-R) score (>4.5), and higher PLR level (>55.73) at the time of the initial diagnosiswere the independent adverse prognostic factors for OS in patients with initial MDS. The patients were also stratified into a demethylat-ing group and a non-demethylating group based on their treatment plans. The results demonstrated that the number of patients whoachieved remission (CR + PR + mCR) after being subjected to demethylating therapy accounted for 70.2% (40/57) of the total remis-sion cases, which was significantly higher than the proportion of patients who achieved remission after non-demethylating therapy(29.8%, 17/57). Notably, among patients in the high PLR group, the number of those who achieved remission following demethylatingtreatment was 76.5% (13/17), substantially greater than the 23.5% (4/17) who responded to non-demethylating therapy. Conclusion PLR and LDH levels can assist the IPSS-R as an evaluation index for assessing the condition of patients with newly diagnosed MDS and the effect of treatment. |
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