【摘 要】
：
目的:68例骨髓增生异常综合征患者按年龄分为老年组与非老年组(老年组36例非老年组32例),对其进行临床及细胞遗传学因素分析,判定各因素对其预后的影响.方法:所有患者同时进
【机 构】
：
常州市第三人民医院,213001常州市第二人民医院,213003
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目的:68例骨髓增生异常综合征患者按年龄分为老年组与非老年组(老年组36例非老年组32例),对其进行临床及细胞遗传学因素分析,判定各因素对其预后的影响.方法:所有患者同时进行常规的细胞遗传学检测,并对5、7、8号染色体进行FISH检测.应用SPSS11.5统计软件,对两组患者的遗传学异常及疾病的发生、转归及预后进行分析.结果:68例患者常规遗传学结果及FISH检测结果如下:22例患者常规细胞遗传学检出异常(老年组14例非老年组8例),40例患者经FISH检出异常(老年组24例非老年组16例).患者中存活28例(老年组10例非老年组18例),死亡36例(老年组23例非老年组13例),失访4例(老年组非老年组各2例);其中20例转化为急性白血病(老年组13例非老年组7例).单因素COX回归模型分析结果显示:患者死亡风险遗传学正常者低于异常患者,FISH578正常者低于FISH578异常者,未转为白血病者低于转为白血病者,年龄越小死亡风险越低,以上差别均有统计学意义(P＜0.05).结论:FISH技术能敏感地检测出小克隆异常,运用常规细胞遗传学技术结合多种探针进行分析,能对MDS患者的诊断、转归及预后进行更为准确的判断.MDS患者的年龄是影响患者预后的独立因素.老年组患者预后明显差于非老年组.
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