营养风险指数、血清铁蛋白、可溶性E钙黏蛋白与急性髓系白血病异基因造血干细胞移植术患者预后的相关性分析

Correlation analysis of nutritional risk index,serum ferritin,soluble E cadherin and prognosis of adult patients with acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation

目的探讨营养风险指数(NRI)、血清铁蛋白(SF)、可溶性E钙黏蛋白(SE-CAD)与成人急性髓系白血病(AML)异基因造血干细胞移植术患者预后的相关性。方法选取2019年1月至2021年12月于空军军医大学第二附属医院接受异基因造血干细胞移植术治疗,且随访至2023年12月的AML患者119例作为研究对象,设立为试验组,同期选取60例健康体检者设立为对照组。对比NRI、SF、SE-CAD水平变化。结果试验组的NRI低于对照组,而SF、SE-CAD水平高于对照组(P<0.05)。不同白细胞计数、血红蛋白水平、骨髓原始细胞比例、FAB分型的NRI、SF水平、SE-CAD水平比较,差异具有统计学意义(P<0.05)。白细胞计数、血红蛋白水平、骨髓原始细胞比例、FAB分型与NRI(r=-0.237、-0.179、-0.357、-0.258,P<0.05)呈负相关,与SF水平(r=0.236、0.212、0.190、0.180,P<0.05)、SE-CAD水平(r=0.328、0.278、0.302、0.256,P<0.05)呈正相关。营养风险指数(NRI)下降和SF水平、SE-CAD水平升高为AML患者术后3年无进展生存时间及总生存时间的独立影响因素(P<0.05)。NRI、SF、SE-CAD及三项联合预测AML患者预后的曲线下面积(AUC)值分别为0.725、0.755、0.756及0.843(P<0.05)。结论在AML患者中NRI异常下降,SF、SE-CAD水平异常升高,可对预后产生不利影响。

Objective To investigate the correlation between nutritional risk index(NRI),serum ferritin(SF),soluble E cadherin(SE-CAD)and prognosis of adult patients with acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation.Method A total of 119 patients with AML who received allogeneic hematopoietic stem cell transplantation in the Second Affiliated Hospital of PLA Air Force Medical University from January 2019 to December 2021 and were followed up until December 2023 were selected as the study subjects,and 60 healthy subjects were selected as the control group during the same period.The changes of NRI,SF and SE-CAD were compared.Result The NRI of experimental group was lower than that of control group,while SF and SE-CAD were higher than that of control group(P<0.05).There were significant differences in NRI,SF and SE-CAD among different WBC count,hemoglobin,bone marrow original cell ratio and FAB classification(P<0.05).White blood cell count,hemoglobin,bone marrow original cell ratio and FAB classification were negatively correlated with NRI and SF,but positively correlated with SE-CAD and NLR(P<0.05).White blood cell count,hemoglobin,bone marrow original cell ratio and FAB classification were negatively correlated with NRI(r=-0.237,-0.179,-0.357,-0.258,P<0.05),but positively correlated with SF(r=0.236,0.212,0.190,0.180,P<0.05)and SE-CAD(r=0.328,0.278,0.302,0.256,P<0.05).The decrease of NRI and the increase of SF and SE-CAD were independent influencing factors for 3-year progression-free survival and overall survival of AML patients after surgery(P<0.05).The AUC values of NRI,SF,SE-CAD and three combinations in predicting the prognosis of AML patients were(0.725,0.755,0.756,0.843,P<0.05).Conclusion The abnormal decrease of NRI and the abnormal increase of SF and SE-CAD in patients with acute myeloid leukemia may have adverse effects on prognosis.