肌萎缩侧索硬化预后相关的血液学标志物

doi:10.6040/j.issn.1671-7554.0.2015.1158

摘要/Abstract

摘要： 目的探讨部分血液指标与肌萎缩侧索硬化(ALS)患者预后的关系,寻找预测ALS患者预后的血液学标志物。方法回顾性分析2007年1月至2012年12月山东大学齐鲁医院收治的116例ALS患者的临床资料和血常规检查结果,采用Kaplan-Meier生存分析计算中位生存时间,Log-rank分析各单因素变量与生存时间的关系,Cox风险比例模型分析多变量对生存时间的影响。结果生存曲线分析显示,具有较高水平白蛋白、肌酐(sCr)、甘油三酯(TG)、低密度脂蛋白/高密度脂蛋白(LDL/HDL)、尿酸(UA)的患者生存时间较长,其中sCr、TG水平与ALS患者生存期呈显著的剂量依赖效应(P<0.05)。多因素分析显示,sCr是影响ALS患者预后的独立因素。结论血脂水平和营养状态与ALS患者预后密切相关,sCr可作为预测ALS患者预后的血液学标志物。

关键词: 肌萎缩侧索硬化, 血液指标, 预后, 血脂, 血清肌酐

Abstract: Objective To investigate the relationship between some of hematological factors and the prognosis of amyotrophic lateral sclerosis(ALS), and search for hematology markers which could predict the prognosis of patients with ALS. Methods The retrospective study included 116 patients with ALS from the Qilu Hospital of Shandong University during January 2007 to December 2012. Their clinical data and routine hematological parameters were collected. Survival of patients was calculated by using the Kaplan-Meier method. The relationship between levels of hematological parameters and the survival curve of patients were analyzed by Log-rank test. Multivariate effect on survival time was analyzed with Cox proportional hazard model. Results The survival increased in patients with higher levels of serum albumin, creatinine(sCr), triglyceride(TG), lowdensity lipoprotein/ high density lipoprotein(LDL/HDL)or uric acid(UA). Moreover, a dose-response effect was found only in sCr and TG(P<0.05). Multivariable analysis showed that only sCr was an independent hematological marker affecting the prognosis of patients with ALS. Conclusion Blood lipid level and nutritional status are associated with survival of ALS patients, and sCr can be used as a potential independent prognostic biomarker of ALS.

Key words: Amyotrophic lateral sclerosis, Hematological parameter, Serum creatinine, Prognosis

中图分类号:

R741

马琳,张冬,唐蕾,叶嗣源,焉传祝,曹丽丽. 肌萎缩侧索硬化预后相关的血液学标志物[J]. 山东大学学报（医学版）, 2016, 54(4): 46-50.

MA Lin, ZHANG Dong, TANG Lei, YE Siyuan, YAN Chuanzhu, CAO Lili. Prognostic hematological biomarkers of amyotrophic lateral sclerosis[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(4): 46-50.

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