现代检验医学杂志2025，Vol.40Issue(3)：139-144,6.DOI:10.3969/j.issn.1671-7414.2025.03.026
骨髓增生异常综合征患者血浆TAT,PIC,TM和t-PAIC水平对总生存期和无白血病生存期的评价及预测价值
Evaluation and Predictive Value of Plasma TAT,PIC,TM and t-PAIC Levels in Patients with Myelodysplastic Syndrome for Overall Survival and Leukemia-free Survival
摘要
Abstract
Objective To investigate the prognostic value of thrombin-antithrombin III complex(TAT),plasmin-α2-plasmin inhibitor complex(PIC),thrombomodulin(TM)and tissue plasminogen activator-inhibitor complex(t-PAIC)in patients with myelodysplastic syndrome(MDS).Methods Selected 88 primary MDS patients diagnosed at the 521 Hospital of Ordnance Industry from January 2018 to January 2021.Plasma levels of TAT,PIC,TM,t-PAIC,fibrin degradation products(FDP)and D-dimer(D-D)were measured.A multivariate approach was used to analyze the association between overall survival(OS)and the levels of each coagulation marker.Coagulation markers significantly associated with OS were used to construct a coagulation prognostic scoring system.Based on the median coagulation marker score,MDS patients were divided into high and low score groups.Kaplan-Meier analysis was used to plot survival curves.Results TAT(OR=1.667),PIC(OR=0.734),TM(OR=1.294)and t-PAIC(OR=1.523)were independent factors influencing OS in MDS patients(Wald χ2=0.671～10.751,all P<0.05).The β-values were integrated as statistical weights to construct a coagulation marker score,calculated as follows:[TAT]×0.502-[PIC]×1.013+[TM]×0.181+[t-PAIC]×0.381.The OS(median 14.6 months)and leukemia free survival(LFS)(median 10.3 months)of patients in the high coagulation marker score group were significantly lower than those in the low score group(33.6 months,35.2 months)(Log rank=20.57,26.84,all P<0.001).Subgroup analysis indicated that in both the low-risk IPSS-R subgroup(very low,low,and intermediate risk)and the high-risk IPSS-R subgroup(high and very high risk),the OS(Log rank=9.12,4.30)and LFS(Log rank=4.54,8.51)of the high coagulation marker score group were lower than those of the low score group(all P<0.05).Bivariate analysis showed a moderate correlation between the coagulation marker score and Revise International Prognostic Scoring System(IPSS-R)(PCC=0.536,P<0.001).Multivariate analysis indicated that IPSS-R and high coagulation marker scores were independent risk factors for OS and LFS in MDS patients(P<0.05).Conclusion The coagulation marker score,based on TAT,PIC,TM and t-PAIC,can serve as an independent prognostic factor for OS and LFS in MDS patients.关键词
凝血酶-抗凝血酶Ⅲ复合物/纤溶酶-α2-纤溶酶抑制剂/血栓调节蛋白/组织型纤溶酶原激活物-抑制剂复合物/骨髓增生异常综合征Key words
thrombin-antithrombin Ⅲ complex/plasmin-α2-plasmin inhibitor complex/thrombomodulin/tissue plasminogen activator-inhibitor complex/myelodysplastic syndrome分类
医药卫生引用本文复制引用
刘静静,刘娟,何佩东,李新红,刘素荣,朱娇,权阳加,王春莹,胡颖辉..骨髓增生异常综合征患者血浆TAT,PIC,TM和t-PAIC水平对总生存期和无白血病生存期的评价及预测价值[J].现代检验医学杂志,2025,40(3):139-144,6.基金项目
陕西省卫生健康科研基金项目(20210449). （20210449）
