外周血破碎红细胞比例与移植相关血栓性微血管病患者临床特点的相关性分析

Correlation between the ratio of schistocytes in peripheral blood and the clinical characteristics of patients with transplantation-associated thrombotic microangiopathy

目的:分析外周血破碎红细胞比例与移植相关血栓性微血管病(TA-TMA)患者临床特点的相关性。方法:回顾性分析2014年01月至2021年12月于郑州大学附属肿瘤医院血液科接受造血干细胞移植(HSCT)后发生TA-TMA患者的实验室和临床资料数据,采用SPSS 21.0软件进行统计学分析。结果:TA-TMA患者外周血破碎红细胞比例与移植-TMA时间是正相关关系(r=0.532,P=0.006),而TA-TMA患者外周血破碎红细胞比例与TA-TMA疗效是负相关关系(r=-0.709,P=0.000);TA-TMA患者外周血破碎红细胞比例预测临床疗效的最佳临界值为3.1%(灵敏度76.9%,特异度83.3%)。结论:外周血破碎红细胞比例是诊断TA-TMA比较直观的实验室指标,随着移植-TMA时间增加而增多,但疗效会越差,3.1%可作为预测疗效的临界值,低于该值治疗效果好。

Objective:To analyze the correlation between the ratio of schistocytes in peripheral blood and the clinical characteristics of patients with transplantation-associated thrombotic microangiopathy(TA-TMA).Methods:Laboratory and clinical data of patients with TA-TMA after receiving hematopoietic stem cell transplantation(HSCT)in hematology department of the Affiliated Cancer Hospital of Zhengzhou University from January 2014 to December 2021 were retrospectively reviewed.SPSS 21.0 software was used for statistical analysis.Results:There was a positive correlation between the ratio of peripheral blood schistocytes in TA-TMA patients and transplant-TMA time(r=0.532,P=0.006),however,there was a negative correlation between the ratio of peripheral blood schistocytes in TA-TMA patients and the therapeutic effect of TA-TMA(r=-0.709,P=0.000).The optimal cut-off value of the ratio of peripheral blood schistocytes in patients with TA-TMA to predict the clinical treatment effect was 3.1%(sensitivity 76.9%,specificity 83.3%).Conclusion:The ratio of schistocytes in peripheral blood is a relatively intuitive laboratory indicator for the diagnosis of TA-TMA.It increases with the increase of transplantation-TMA time,but the curative effect will be worse.3.1%can be used as a critical value for predicting curative effect.Below this value,the treatment effect is better.