Charlson指数对多发性骨髓瘤老年病人的预后评估价值

The value of charlson index in the evaluation of prognosis in elderly multiple myeloma

目的探讨Charlson指数在老年多发性骨髓瘤病人预后的评估价值。方法选择2015年1月至2018年1月如皋市人民医院收治的老年多发性骨髓瘤84例作为研究对象,对所有病人临床资料进行回顾性分析。所有病人根据Charlson指数评分标准分为A组(≥5分)22例、B组(<5分)62例,对两组病人临床特征、实验室指标进行单因素、多因素分析,并对比两组生存时间。结果Charlson指数评分≥5分、年龄≥75岁、ISS分期Ⅲ期、血清肌酐(SCr)≥176.8μmol/L、血红蛋白(Hb)<100 g/L、乳酸脱氢酶(LDH)>245 U/L是影响老年多发性骨髓瘤病人预后的危险因素(P=0.000,0.026,0.014,0.014,0.035,0.000);Charlson指数评分≥5分、LDH>245 U/L是影响老年多发性骨髓瘤病人预后的独立危险因素(均P<0.001);B组中位生存期为46个月,长于A组的26个月(P<0.001)。结论Charlson指数应用于评估老年多发性骨髓瘤病人预后效果具有显著临床价值,值得推广。

Objective To investigate the value of Charlson index in the evaluation of prognosis of elderly patients with multiple my⁃eloma.Methods Eighty⁃four patients with multiple myeloma admitted to Rugao people’s Hospital from January 2015 to January 2018 were selected as the study subjects.All patients were retrospectively analyzed.All patients were divided into group A(≥5 points)22 cases and group B(<5 points)62 cases according to the Charlson index scoring standard.The clinical characteristics and laboratory parameters of the two groups were analyzed by univariate and multivariate analysis.The group survival time were compared.Results Charlson’s index score≥5,age≥75,ISS stageⅢ,serum creatinine(SCR)≥176.8μmmol/L,hemoglobin(HB)<100 g/L,lactate dehydrogenase(LDH)>245 U/L were risk factors affecting the prognosis of patients with multiple myeloma(P=0.000,0.026,0.014,0.014,0.035,0.000).Charlson index score≥5 points,LDH>245 U/L is an independent risk factor affecting the prognosis of patients with multiple myeloma in the elderly(all P<0.001).The median survival time of group B was 46 months,which was longer than 26 months of group A,and the difference was statistically significant(P<0.001).Conclusion The Charl⁃son index has significant clinical value in evaluating the prognosis of patients with multiple myeloma in the elderly,which worthy of promotion.