中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
18期
1374-1377
,共4页
肖霞%赵明峰%孟娟霞%李青%穆娟%李新%吕海容%刘鹏江%邓琦
肖霞%趙明峰%孟娟霞%李青%穆娟%李新%呂海容%劉鵬江%鄧琦
초하%조명봉%맹연하%리청%목연%리신%려해용%류붕강%산기
红细胞增多症,真性%老年人%基因,JAK2 V617F%血栓形成
紅細胞增多癥,真性%老年人%基因,JAK2 V617F%血栓形成
홍세포증다증,진성%노년인%기인,JAK2 V617F%혈전형성
Polythemia vera%Aged%Genes,JAK2 V617F%Thrombosis
目的 分析老年真性红细胞增多症(PV)患者的疾病特征及预后.方法 回顾性分析自2009年1月至2013年12月就诊于天津市第一中心医院血液科诊断为PV的患者,共140例,包括68例年龄≥60岁的老年PV患者和72例年龄＜60岁的非老年PV患者,对老年PV患者的疾病特点和临床结果进行分析,并与非老年患者进行比较.结果 老年组患者较非老年组患者具有更多的血栓病史[54.4％ (37/68)比30.6％(22/72),P=0.004],较高的心脑血管危险因素[63.2％ (43/68)比36.1％(26/72),P=0.001],较高的高白细胞[(13.9 ±3.8)×109/L比(7.8 ±2.2)×109/L,P=0.000)和JAK2V617F基因突变负荷[62％ (30％ ～81％)比41％ (26％ ～63％),P=0.035].老年组患者较非老年组患者血管并发症发生率更高[54.4％(37/68)比30.6％(22/72),P=0.004],更易向骨髓纤维化转化[11.8％ (8/68)比2.8％(2/72),P=0.039],二者白血病转化率分别为4.4％ (3/68)和0(0/72),但差异无统计学意义(P =0.112).老年组患者预后不佳,较非老年组患者有更高的病死率[14.7％ (10/68)比4.2％(3/72),P=0.032].结论 老年PV患者危险因素增多,多为高危患者,更易合并血栓及向骨髓纤维化、白血病转化.预防或延迟并发症发生是目前治疗目标,以减少疾病进展及病死率.
目的 分析老年真性紅細胞增多癥(PV)患者的疾病特徵及預後.方法 迴顧性分析自2009年1月至2013年12月就診于天津市第一中心醫院血液科診斷為PV的患者,共140例,包括68例年齡≥60歲的老年PV患者和72例年齡＜60歲的非老年PV患者,對老年PV患者的疾病特點和臨床結果進行分析,併與非老年患者進行比較.結果 老年組患者較非老年組患者具有更多的血栓病史[54.4％ (37/68)比30.6％(22/72),P=0.004],較高的心腦血管危險因素[63.2％ (43/68)比36.1％(26/72),P=0.001],較高的高白細胞[(13.9 ±3.8)×109/L比(7.8 ±2.2)×109/L,P=0.000)和JAK2V617F基因突變負荷[62％ (30％ ～81％)比41％ (26％ ～63％),P=0.035].老年組患者較非老年組患者血管併髮癥髮生率更高[54.4％(37/68)比30.6％(22/72),P=0.004],更易嚮骨髓纖維化轉化[11.8％ (8/68)比2.8％(2/72),P=0.039],二者白血病轉化率分彆為4.4％ (3/68)和0(0/72),但差異無統計學意義(P =0.112).老年組患者預後不佳,較非老年組患者有更高的病死率[14.7％ (10/68)比4.2％(3/72),P=0.032].結論 老年PV患者危險因素增多,多為高危患者,更易閤併血栓及嚮骨髓纖維化、白血病轉化.預防或延遲併髮癥髮生是目前治療目標,以減少疾病進展及病死率.
목적 분석노년진성홍세포증다증(PV)환자적질병특정급예후.방법 회고성분석자2009년1월지2013년12월취진우천진시제일중심의원혈액과진단위PV적환자,공140례,포괄68례년령≥60세적노년PV환자화72례년령＜60세적비노년PV환자,대노년PV환자적질병특점화림상결과진행분석,병여비노년환자진행비교.결과 노년조환자교비노년조환자구유경다적혈전병사[54.4％ (37/68)비30.6％(22/72),P=0.004],교고적심뇌혈관위험인소[63.2％ (43/68)비36.1％(26/72),P=0.001],교고적고백세포[(13.9 ±3.8)×109/L비(7.8 ±2.2)×109/L,P=0.000)화JAK2V617F기인돌변부하[62％ (30％ ～81％)비41％ (26％ ～63％),P=0.035].노년조환자교비노년조환자혈관병발증발생솔경고[54.4％(37/68)비30.6％(22/72),P=0.004],경역향골수섬유화전화[11.8％ (8/68)비2.8％(2/72),P=0.039],이자백혈병전화솔분별위4.4％ (3/68)화0(0/72),단차이무통계학의의(P =0.112).노년조환자예후불가,교비노년조환자유경고적병사솔[14.7％ (10/68)비4.2％(3/72),P=0.032].결론 노년PV환자위험인소증다,다위고위환자,경역합병혈전급향골수섬유화、백혈병전화.예방혹연지병발증발생시목전치료목표,이감소질병진전급병사솔.
Objective To analyze the clinical features of elderly patients with polythemia vera (PV) Methods Statistical analyses were performed for the clinical features of 68 PV patients of age ≥ 60 years and 72 PV patients of age ＜ 60 years from January 2009 to December 2013 in our hospital.Results Compared with younger patients,elderly patients with PV had higher incidences of thrombosis (54.4％ (37/68) vs 30.6％ (22/72),P =0.004),more risk factors of cardio-cerebrovascular (63.2％ (43/68) vs 36.1％ (26/72),P =0.001),higher white blood cell counts ((13.9 ± 3.8) × 109/L vs (7.8 ± 2.2) ×109/L,P =0.000) and higher JAK2 V617F allele burden(62％ (30％-81％) vs 41％ (26％-63％),P =0.035).There was higher incidences of vascular complications in elderly patients with PV (54.4％ (37/ 68) vs 30.6％ (22/72),P =0.004).Myelofibrosis transformation occurred with higher frequency in elderly patients with PV (11.8 ％ (8/68) vs 2.8 ％ (2/72),P =0.039).And there was no significant difference in the frequency of leukemia transformation between elderly patients and younger patients (4.4％ (3/68)vs 0 (0/72),P =0.112).There was higher mortality rate in elderly patients with PV (14.7％ (10/86) vs 4.2％ (3/72),P =0.032).Conclusions There are more risk factors in elderly patients with PV.The elderly patients with PV has high risk to complicat with thrombosis and transformated to myelofibrosis and leukemia.Prevention or delay of these complications is currently the goal of treatment,so that it could reduce the mortality rate and disease progression.
