| 闻才李,张慧,王思贤,等.老年急性髓系白血病患者不良预后的独立影响因素及预测价值[J].中国临床保健杂志,2026,29(2):226-230. |
| 老年急性髓系白血病患者不良预后的独立影响因素及预测价值 |
| Independent influencing factors and predictive value of poor prognosis in elderly patients with acute myeloid leukemia |
| 投稿时间：2025-12-02 |
| DOI：10.3969/J.issn.1672-6790.2026.02.016 |
| 中文关键词: 急性髓系白血病 影响因素分析 预测 预后 老年人 |
| 英文关键词: Acute myeloid leukemia Root cause analysis Forecasting Prognosis Aged Fund program:Natural Science Research Project of Minhang District,Shanghai |
| 基金项目:上海市闵行区自然科学研究课题 |
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| 中文摘要: |
| 目的 探讨老年急性髓系白血病(AML)患者不良预后的独立影响因素及预测价值。方法 回顾性分析2022年1月至2024年12月复旦大学附属闵行医院收治的108例老年AML患者临床资料。根据患者随访6个月的预后结局分组,分为预后良好组(72例)和预后不良组(36例)。比较两组患者的一般资料及外周血中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)、血小板与淋巴细胞比值(PLR)、抗凝血酶Ⅲ(AT-Ⅲ)水平的表达情况的差异；采用多因素logistic回归分析老年AML患者不良预后的独立影响因素,绘制受试者操作特征(ROC)曲线分析上述独立影响因素指标对老年AML不良预后的预测价值。结果 预后不良组患者的年龄、ECOG体能评分、合并基础疾病数、白细胞计数、骨髓原始细胞比例、NLR、MLR、PLR均显著高于预后良好组,AT-Ⅲ显著低于预后良好组,差异均有统计学意义(均P<0.05)。多因素logistic回归分析证实,年龄、骨髓原始细胞比例、NLR、MLR、PLR、AT-Ⅲ是老年AML患者不良预后的独立影响因素(P<0.05)。ROC曲线分析显示,上述指标均对老年AML患者不良预后具有预测价值,且年龄、骨髓原始细胞比例、NLR、MLR、PLR、AT-Ⅲ联合预测的AUC值最高(0.990)。结论 年龄、骨髓原始细胞比例、NLR、MLR、PLR及AT-Ⅲ是老年AML患者不良预后的独立影响因素,单一指标均具有一定预测价值,联合检测可显著提升预测效能。 |
| 英文摘要: |
| Objective To explore the independent influencing factors and predictive value of poor prognosis in elderly patients with acute myeloid leukemia (AML).Methods The clinical data of 108 elderly patients with AML admitted to Minhang Hospital Affiliated to Fudan University from January 2022 to December 2024 were retrospectively analyzed.Based on the prognosis outcomes of patients followed up for 6 months,they were grouped into two categories:the good prognosis group (72 cases) and the poor prognosis group (36 cases).The general data and expressions of neutrophil-to-lymphocyte ratio (NLR),monocyte-to-lymphocyte ratio (MLR),platelet-to-lymphocyte ratio (PLR) and antithrombin Ⅲ (AT-Ⅲ) in peripheral blood were compared between the two groups.Multivariate logistic regression analysis was used to analyze the independent influencing factors affecting the poor prognosis in elderly AML patients.Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of the above independent influencing factors on the poor prognosis in elderly AML patients.Results Univariate analysis showed that the age,ECOG physical fitness score,number of concurrent underlying diseases,WBC,proportion of bone marrow primitive blast cells,NLR,mLR and PLR in poor prognosis group were significantly higher than those in good prognosis group while the AT-Ⅲ level was significantly lower than that in good prognosis group (P<0.05).Multivariate Logistic regression analysis confirmed that age,proportion of bone marrow blast cells,NLR,mLR,PLR and AT-Ⅲ were independent influencing factors for poor prognosis in elderly AML patients (P<0.05).ROC curve analysis showed that all the above indexes had predictive value on the poor prognosis in elderly AML patients,and the AUC value of the combined prediction of age,proportion of bone marrow blast cells,NLR,MLR,PLR,and AT-III was the highest (0.990).Conclusions Age,proportion of bone marrow blast cells,NLR,mLR,PLR and AT-Ⅲ are independent influencing factors affecting the poor prognosis in elderly AML patients,and the indexes above have certain predictive value,and combined detection can significantly enhance the predictive efficiency. |
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