慢性淋巴细胞白血病患者并发非甲状腺疾病综合征的预后

Prognosis of chronic lymphocytic leukemia patients with non-thyroidal illness syndrome

目的 :探讨非甲状腺疾病综合征(non-thyroidal illness syndrome,NTIS)在慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)患者中的发生率、临床特征及预后。方法 :检测78例CLL患者的甲状腺功能,结合临床资料分析NTIS发病的可能诱因、临床表现及发病后的总生存期(overall survival,OS)。结果:78例CLL患者中14例并发NTIS,NTIS与疾病晚期(Binet C期)(P=0.021)、血红蛋白减少(P<0.001)、血小板计数减低(P=0.012)、低白蛋白血症(P=0.018)和高C反应蛋白水平(P=0.007)显著相关。生存分析显示,伴NTIS患者的中位OS明显短于无NTIS者(P<0.001)。结论 :部分CLL患者伴发NTIS,推测其原因可能与CLL患者全身炎症反应或营养状态恶化有关,伴NTIS提示预后不良。

Objective：To assess the prevalence,clinical characteristics and prognostic accuracy of non-thyroidal illness syndrome（NTIS）in patients with chronic lymphocytic leukemia （CLL）. Methods：Thyroid function and clinical data were examined in 78 patients with CLL to identify potential predisposing factors,evaluate clinical features and overall survival（OS）. Results：Among 78 CLL patients,14 patients were diagnosed as NTIS. NTIS of CLL was significantly correlated with advanced Binet stage （Binet C）（P=0.021）,decreased hemoglobin（P 〈 0.001）,platelet count（P=0.012）and albumin（P=0.018）,and increased C reaction protein（CRP）（P=0.007）. The patients with NTIS had shorter median OS than patients without NTIS （P 〈 0.001）. Conclusion：NTIS was present in some CLL patients,and that may be related with systemic inflammation and nutritional decline of patients. CLL patients with NTIS have a poor prognosis.