急性髓系白血病中医证型分布及相关性研究

A study on the distribution and correlation of TCM syndromes of acute myeloid leukemia

目的:了解急性髓系白血病中医证型分布,探讨不同中医分型急性髓系白血病与临床特点、实验室检验检查、预后危险度分层及生存的相关性。方法:回顾性收集初诊急性髓系白血病病例共84例,统计中医证型、临床资料、外周血实验室指标、骨髓检查及预后危险度分层,随访生存时间,分析初诊急性髓系白血病不同中医证型分布、临床特点、实验室检验检查、预后危险度分层及生存的差异。结果:84例初诊急性髓系白血病患者中,瘀血痰结证比例最多,毒热炽盛证次之,气阴两虚证最少。不同中医证型初诊急性髓系白血病患者[外周血白细胞(White Blood Cell,WBC)、血红蛋白(Hemoglobin,Hb)、乳酸脱氢酶(Lactate Dehydrogenase,LDH)]水平差异有统计学意义(P<0.01),基于细胞遗传学/分子遗传学的预后危险度分层差异有统计学意义(P<0.05),不同中医证型初诊急性髓系白血病患者生存情况的差异有统计学意义(P<0.05),但年龄、性别、血型、吸烟史、高血压病史、糖尿病史、血液病史、血小板(Platelet,PLT)计数、骨髓免疫表型是否伴有CD7+及染色体核型差异均无统计学意义(P>0.05)。结论:初诊急性髓系白血病中医分型诊断可辅助分析预后,外周血WBC、Hb、LDH水平有助于中医分型诊断。

Objective:To understand the distribution of TCM syndrome types of acute myeloid leukemia(AML)and explore the correlation between TCM syndrome types and clinical characteristics,laboratory inspection,prognostic risk stratification,and survival.Methods:A total of 84 newly diagnosed AML cases were retrospectively collected.The TCM syndrome types,clinical data,laboratory indicators of peripheral blood,bone marrow examination,prognostic risk stratification,and the follow-up survival time were statistically analyzed,and the distribution of different TCM syndrome types of newly diagnosed AML,the differences in clinical characteristics,laboratory inspection,prognostic risk stratification,and survival among different syndrome types were compared.Results:Among the 84 newly diagnosed AML patients,the proportion of inter-accumulation of blood stasis and phlegm syndrome was the highest,followed by the toxic heat inflaming syndrome,and deficiency of Qi(气)and Yin(阴)syndrome was the lowest.The levels of white blood cells(WBC),hemoglobin(Hb)and lactate dehydrogenase(LDH)in peripheral blood of newly diagnosed AML patients with different TCM syndromes were significantly different(P<0.01),and the prognostic risk stratification based on cytogenetics/molecular genetics had a statistical significance(P<0.05).In addition,there was a statistical difference in survival of newly diagnosed AML among different TCM syndromes(P<0.05).However,there were no significant differences in age,gender,blood type,smoking history,hypertension history,diabetes history,hematological diseases history,platelet count,bone marrow immunophenotype with CD7+and chromosome karyotype(P>0.05).Conclusion:The TCM syndrome types of newly diagnosed AML can assist in the analysis of prognosis,and the levels of WBC,Hb and LDH in peripheral blood are helpful for diagnosis of the TCM syndrome types.