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预后营养指数联合尿素–肌酐比值对单倍体造血干细胞移植患者移植预后的评估价值
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Abstract:
本研究探讨了移植前作为潜在的预测指标，预后营养指数(PNI)和尿素–肌酐比值(UCR)对单倍体造血干细胞移植(HID-HSCT)患者结局的影响。通过对55例行HID-HSCT患者移植前的临床数据进行了回顾性分析。采用生存曲线比较不同组别的总生存期(OS)和无进展生存期(PFS)。研究发现与低PNI组(PNI < 38.6)相比，高PNI组(PNI ≥ 38.6)的OS (P = 0.0394)和PFS (P = 0.0417)更好。两组的3年OS分别为34.6%和74.1%。与高UCR组(UCR ≥ 54.1)相比，低UCR组(UCR < 54.1)的OS (P < 0.0480)和PFS (P < 0.0454)更优，3年OS率分别为43.7%和84.5%。此外，与其他三组相比，低PNI + 高UCR组患者的OS和PFS更差，3年OS率差异有统计学意义。多变量分析结果显示，PNI + UCR (HR = 2.424, 95% CI: 1.985~5.965, P = 0.047)是影响患者OS的独立风险因素。结论：移植前高PNI、高UCR、低PNI + 高UCR的患者行HID-HSCT预后较差。
This study investigated the impact of pretransplantation, as potential predictors, prognostic nutritional index (PNI) and urea-creatinine ratio (UCR) on the outcome of haploidentical hematopoietic stem cell transplantation (HID-HSCT) patients. Clinical data from 55 HID-HSCT patients before transplantation were analyzed retrospectively. Survival curves were used to compare overall survival (OS) and progression-free survival (PFS) in different groups. It was found that OS (P = 0.0394) and PFS (P = 0.0417) were better in the high PNI group (PNI ≥ 38.6) compared to the low PNI group (PNI < 38.6). The 3-year OS of the two groups were 34.6% and 74.1%, respectively. Compared with the high UCR group (UCR ≥ 54.1), the low UCR group (UCR < 54.1) had better OS (P < 0.0480) and PFS (P < 0.0454), with 3-year OS rates of 43.7% and 84.5%, respectively. In addition, patients in the low PNI + high UCR group had worse OS and PFS compared with the other three groups, and the difference in 3-year OS rates was statistically significant. The results of multivariate analysis showed that PNI + UCR (HR = 2.424, 95% CI: 1.985~5.965, P = 0.047) was an independent risk factor affecting patients’ OS. Conclusion: Patients with high PNI, high UCR, and low PNI + high UCR before transplantation underwent HID-HSCT with a poorer prognosis.
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