Page 71 - 南京医科大学学报自然科学版

第43卷第6期 南京医科大学学报（自然科学版）
2023年6月 Journal of Nanjing Medical University（Natural Sciences） ·813 ·

·临床研究·

营养状态在弥漫大B细胞淋巴瘤患者中的预后意义

卢传洋，陈秋妮，史玉叶，王春玲，于 亮 *
南京医科大学附属淮安第一医院血液科，江苏 淮安 223300

［摘 要］ 目的：探讨营养状态指标包括控制营养状态（controlling nutritional status，CONUT）评分和预后营养指数（prognostic
nutritional index，PNI）在预测弥漫大B细胞淋巴瘤（diffuse large B cell lymphoma，DLBCL）预后中的作用。方法：回顾性收集105例
在南京医科大学附属淮安第一医院血液科就诊的DLBCL患者的临床资料，计算出每个患者的CONUT评分和PNI，并通过ROC
曲线确定截断值。CONUT评分和PNI分别以6.5和47.28作为截断值，将患者根据截断值进行分组。依次进行Kaplan⁃Meier生
存分析、单因素和多因素COX回归分析以及Spearman 相关分析。结果：生存曲线显示CONUT 评分和PNI对患者的总生存期
（overall survival，OS）具有预测作用（P＜0.05）。单因素分析显示 CONUT 评分、PNI、国际预后指数（international prognostic in⁃
dex，IPI）危险度分型、白蛋白、胆固醇均是患者OS的预后因素。多因素分析结果表明CONUT评分对DLBCL患者的OS具有独
立预测作用（HR=2.742，95%CI：1.030~7.300，P＜0.05），PNI 不是患者 OS 的独立预测因素（HR=0.526，95%CI：0.135~2.047，P=
0.35）。相关性分析结果显示两种营养状态指标呈高度负相关（r=-0.79，P＜0.01）。结论：CONUT评分是DLBCL患者预后的独
立预测因素，患者CONUT评分越高，预后越差。
［关键词］ 控制营养状态评分；预后营养指数；弥漫大B细胞淋巴瘤；总生存期；预后
［中图分类号］ R733.4 ［文献标志码］ A ［文章编号］ 1007⁃4368（2023）06⁃813⁃07
doi：10.7655/NYDXBNS20230610

The prognostic significance of nutritional status in patients with diffuse large B cell
lymphoma

LU Chuanyang，CHEN Qiuni，SHI Yuye，WANG Chunling，YU Liang *
Department of Hematology，the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University，Huaian
223300，China

［Abstract］ Objective：The current study aims to investigate the prognostic role of nutritional status，including controlling nutritional
status（CONUT）score and prognostic nutritional index（PNI），in patients with diffuse large B cell lymphoma（DLBCL）. Methods：The
clinical data of 105 patients with DLBCL at the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University were
retrospectively collected. And the patients’CONUT score and PNI were calculated. The cut⁃off values of CONUT score and PNI were
determined by ROC curves，and were 6.5 and 47.28 respectively. The patients were grouped according to the cut⁃off values. Kaplan⁃
Meier survival analysis，univariate and multivariate COX regression analysis and Spearman correlation analysis were performed
sequentially. Results：Survival curves demonstrated that CONUT score and PNI had a predictive effect on OS of patients（P < 0.05）.
Univariate analysis showed that CONUT score，PNI，IPI risk score，albumin and cholesterol were prognostic factors for OS of patients.
The results of multivariate analysis showed that CONUT score had an independent prognostic effect on OS in DLBCL patients（HR=
2.742，95%CI：1.030~7.300，P < 0.05），and PNI was not an independent prognostic factor for OS of patients（HR=0.526，95%CI：
0.135~2.047，P=0.35）. Correlation analysis showed a high negative correlation between the two nutritional status indicators（r=-0.79，
P < 0.01）. Conclusion：The CONUT score is an independent prognostic factor for DLBCL patients，and the higher the CONUT score of
patients，the worse the prognosis.
［Key words］ controlling nutritional status score；prognostic nutritional index；diffuse large B cell lymphoma；overall survival；prognosis
［J Nanjing Med Univ，2023，43（06）：813⁃819］

［基金项目］ 2022年淮安市第一人民医院青年创新人才项目（QC202218）；2018年江苏省卫生健康委员会项目（H2018085）
∗
通信作者（Corresponding author），E⁃mail：yuliangha@163.com