天津医药

天津医药 ›› 2022, Vol. 50 ›› Issue (1): 78-82.doi: 10.11958/20211720

• 临床研究 • 上一篇    下一篇

原发性血小板增多症及真性红细胞增多症患者炎性指标与血栓事件的相关性研究

高冠论1，魏婷1，许娜2，周璇2，张星1，李庆山1△   

  1. 1广州市红十字会医院（暨南大学附属广州红十字会医院）血液科（邮编510220）；2南方医科大学南方医院血液科
  • 收稿日期:2021-07-26 修回日期:2021-08-15 出版日期:2022-01-15 发布日期:2022-01-19
  • 通讯作者: 高冠论 E-mail:707602892@qq.com
  • 基金资助:
    国家自然科学基金资助项目（81700104）

Relationship between inflammatory indexes and thrombotic events in essential thrombocythemia and polycythemia vera patients

GAO Guanlun1, WEI Ting1, XU Na2, ZHOU Xuan2, ZHANG Xing1, LI Qingshan1△   

  1. 1 Department of Hematology, Guangzhou Red Cross Hospital (Guangzhou Red Cross Hospital Affiliated to Jinan University), Guangzhou 510220, China; 2 Department of Hematology, Nanfang Hospital of Southern Medical University
  • Received:2021-07-26 Revised:2021-08-15 Published:2022-01-15 Online:2022-01-19

PDF (PC)

2905

摘要：

摘要：目的　分析原发性血小板增多症（ET）及真性红细胞增多症（PV）患者炎性指标与血栓事件的关系，为血栓形成判断及治疗提供依据。方法　回顾性分析97例骨髓增殖性肿瘤患者（ET 54例，PV 43例）的临床资料，根据患者是否发生血栓事件分为血栓组（52例）和非血栓组（45例）。绘制受试者工作特征（ROC）曲线评价中性粒细胞与淋巴细胞比值（NLR）、超敏C反应蛋白（hs-CRP）及正五聚蛋白3（PTX3）对血栓形成的预测价值。比较血栓组和非血栓组患者的临床特征差异，多因素Logistic回归分析患者发生血栓事件的危险因素。结果　52例（53.61%）发生血栓事件的患者中，ET组、PV组分别有28例（51.85%）和24例（55.81%）。ROC曲线结果显示，NLR、hs-CRP及PTX3的最佳截断值分别为3.14、1.75 mg/L、0.915 μg/L，高水平的NLR、hs-CRP及PTX3组较低水平组血栓事件发生率高（χ2分别为15.715、15.255和18.657，P＜0.01）。血栓组年龄、hs-CRP、PTX3、NLR和JAK2基因阳性率明显高于非血栓组（P＜0.05）。多因素Logistic分析结果示，高龄及高PTX3水平是影响患者发生血栓事件的独立危险因素，高龄是ET或PV患者发生血栓事件的独立危险因素（P＜0.05）。结论　高水平hs-CRP、PTX3及NLR的ET和PV患者血栓事件的发生率较高，年龄和PTX3水平可以作为评估患者血栓形成的重要指标。

关键词: 真性红细胞增多症；血栓形成；血小板增多, 原发性；超敏C反应蛋白；正五聚蛋白3；中性粒细胞/淋巴细胞比值

Abstract:

Abstract: Objective　To analyze the relationship between inflammatory indexes and thrombotic events in patients with primary thrombocytosis (ET) and polycythemia vera (PV), so as to provide basis for the judgment and treatment of thrombosis. Methods　The clinical data of 97 patients with bone marrow proliferative tumor (MPN) including 54 cases of ET and 43 cases of PV were analyzed retrospectively. According to whether there were thrombotic events, the patients were divided into the thrombotic group (n=52) and the non-thrombotic group (n=45). The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of neutrophil lymphocyte ratio (NLR), high-sensitivity C-reactive protein (hs-CRP) and positive pentameric protein 3 (PTX3) in thrombosis. The clinical characteristics of patients were compared between the thrombotic group and the non-thrombotic group. Multivariate Logistic regression analysis was used to analyze the risk factors of thrombotic events. Results　Among 52 patients with thrombotic events (53.61%), 28 patients (51.85%) were in the ET group and 24 patients (55.81%) were in the PV group. The results of ROC curve showed that the best cut-off values of NLR, hs CRP and PTX3 were 3.14, 1.75 mg/L and 0.915 μg/L, respectively. The incidence rates of thrombotic events were higher in the high-level NLR, hs-CRP and PTX3 groups than that in the low-level group (χ2 were 15.715, 15.255 and 18.657, respectively, P＜0.01). In all patients, the age, hs CRP, PTX3, NLR and JAK2 gene positive rates were significantly higher in the thrombotic group than those in the non-thrombotic group (P＜0.05). Multivariate Logistic analysis showed that the elderly and high PTX3 level were independent risk factors for thrombotic events in all patients, and the elderly were independent risk factors for thrombotic events in patients with ET or PV (P＜0.05). Conclusion　ET and PV patients with high levels of hs-CRP, PTX3 and NLR have a higher incidence of thrombotic events. Age and PTX3 levels can be used as important indicators to assess thrombosis in patients. 

Key words: polycythemia vera, thrombosis, thrombocythemia, essential, high sensitivity C-reactive protein, pentraxin-3, neutrophil/lymphocyte ratio

中图分类号: