骨髓增生异常综合征预后因素分析

Analysis of Prognostic Factors in Myelodysplastic Syndromes

目的：探讨ＭＤＳ初诊时临床表现及实验室多参数对预后的影响。以利于采取有效的防治对策。方法：采用病例对照方法研究不同年龄、性别、初诊临床表现、ＦＡＢ分型、实验室检查的ＭＤＳ患者的转白率和中数生存期，并对ＭＤＳ死亡危险因素进行多元回归分析。结果：剧烈骨痛、Ｈｂ＜ ３０ｇ／Ｌ、外周血粒系发育异常、ＲＡＥＢ、ＲＡＥＢ－Ｔ ＭＤＳ亚型、骨髓或外周血原始细胞＞ ５％ 、伴发ＭＦ和ＡＬＩＰ（＋ ）、－ ７／７ｑ－ ，＋ ８ 染色体异常或复合染色体异常为ＭＤＳ预后不良因素。而Ｈｂ＞ ９０ ｇ／Ｌ、核型正常或单纯５ ｑ－ 、２０ ｑ－ 、１３ ｑ－ 则预后较好。结论：ＭＤＳ患者初诊时临床表现、实验室指标与预后有关。综合分析上述因素将可能提供ＭＤＳ有价值的预后信息。

Objective:In order to know prognostic factors of myelodysplastic syndromes(MDS). Methods:The care control study was used. Multiple regression was used to analysis the prognostic factors. Results:The risk factors for leukemic transformation and early death were bone ache, Hb<30 g/L, dysplastic peripheral blood polymorphs, RAEB,RAEB T of MDS subtype, blast of bone marrow and peripheral blood>5%,with advancing myelofibrosis, ALIP(+),-7/7q - +8 and cytogenetic abnormalities at more than two chromosomes. By contrast, the cases with Hb>90 g/L, chromosomal normalities or alone 5 q -、20 q -、13 q - chromosomal abnormalities had a favorable prognosis. Conclusion:The primal clinical features and experimental parameters in patients with MDS provides information in determining their prognosis.