高密度脂蛋白与骨髓增生异常综合征患者的预后关系研究

Relationship between high density lipoprotein and prognosis of patients with myelodysplastic syndrome

目的:探讨高密度脂蛋白(HDL)与骨髓增生异常综合征(MDS)预后的关系。方法:收集2013年1月—2019年1月224例初诊MDS患者的临床资料并进行统计分析。结果:全部患者分为HDL≥1 mmol/L组(121例)和HDL<1 mmol/L组(103例)。HDL≥1 mmol/L组患者的中位总生存时间为86个月(95%CI 44~127),HDL<1 mmol/L组患者的中位总生存时间为19个月(95%CI 3~34),2组比较差异有统计学意义(P<0.001)。HDL<1 mmol/L组中IPSS-R中危/高危/极高危患者比例明显高于HDL≥1 mmol/L组(82.5%vs 68.6%,P=0.016)。Cox多因素分析显示,HDL<1 mmol/L为原始细胞<5%的MDS患者的预后不良因素(HR=2.17,95%CI 1.16~4.08,P=0.016)。结论:在MDS患者中,低水平的HDL与更差的IPSS-R预后分层相关,低水平的HDL可以作为评估成人初诊原始细胞<5%的MDS患者预后的危险因素。

Objective:To explore the relationship between high density lipoprotein(HDL)and the prognosis of myelodysplastic syndrome(MDS).Methods:The clinical data of 224 newly diagnosed patients with MDS from January 2013 to January 2019 were collected and analyzed.Results:All patients were divided into HDL≥1 mmol/L group(121 cases)and HDL<1 mmol/L group(103 cases).The median overall survival time of patients with HDL≥1 mmol/L was 86 months(95%CI 44-127),and that of patients with HDL<1 mmol/L was 19 months(95%CI 3-34).There was significant difference between the two groups(P<0.001).The proportions of IPSS-R intermediate/high/very high risks in HDL<1 mmol/L group was significanlty higher than that in HDL≥1 mmol/L group(82.5%vs 68.6%,P=0.016).Cox multivariate analysis showed that HDL<1 mmol/L was a poor prognostic factor in MDS patients with bone marrow blasts<5%(HR=2.17,95%CI 1.16-4.08,P=0.016).Conclusion:In MDS patients,low level of HDL is associated with more advanced IPSS-R prognostic risk categories.Low level of HDL can be used as a risk factor to evaluate the prognosis of adult newly diagnosed MDS patients with bone marrow blasts<5%.