Page 79 - 南京医科大学自然版

第45卷第5期 南京医科大学学报（自然科学版）
2025年5月 Journal of Nanjing Medical University（Natural Sciences） ·665 ·

·临床研究·

免疫调节剂治疗初诊多发性骨髓瘤患者发生血栓事件的临床

意义及血栓量表预测效能比较

姚 叶，史青林，金媛媛，沈旭星，陈丽娟 *

南京医科大学第一附属医院血液科，江苏 南京 210029

［摘 要］ 目的：探讨静脉血栓栓塞症（venous thrombosis embolism，VTE）对接受含免疫调节剂（immunomodulatory drug，IMiD）
方案治疗的初诊多发性骨髓瘤（multiple myeloma，MM）患者预后的影响及其危险因素，并比较血栓量表的预测效能。方法：回
顾性分析 2016年1月—2022年 10月南京医科大学第一附属医院血液科应用IMiD治疗的初诊MM患者的临床资料，分析VTE
与MM患者预后的相关性。采用Padua评分、SAVED评分及IMPEDE 评分对患者进行VTE风险的量化评估，依据受试者工作
特征（receiver operating characteristic，ROC）曲线和曲线下面积（area under curve，AUC）比较 3 种血栓评估量表对初诊 MM 患者
发生VTE的预测效能。结果：共纳入初诊MM患者221例，VTE发生率为15.8%。VTE患者中年龄超过75岁、有中心静脉置管、
近期手术、制动、髓外病变、蒽环类药物应用、合并自身免疫病、低白蛋白血症的发生率较高，其中高龄、中心静脉置管、合并自
身免疫病、低白蛋白血症是导致 MM 患者发生 VTE 的独立危险因素。在预测初诊 MM 患者 VTE 形成的效能评估中，IM⁃
PEDE评分优于另外两种评分体系。结论：高龄、中心静脉置管、合并自身免疫病、低白蛋白血症是导致VTE形成的独立危险
因素，IMPEDE评分预测效能更优。
［关键词］ 静脉血栓栓塞；多发性骨髓瘤；血栓风险评估；预后
［中图分类号］ R733.3 ［文献标志码］ A ［文章编号］ 1007⁃4368（2025）05⁃665⁃06
doi：10.7655/NYDXBNSN241131

Clinical significance of thrombotic events in newly diagnosed multiple myeloma patients

treated with IMiDs and comparison of thrombosis risk score predication efficacy

YAO Ye，SHI Qinglin，JIN Yuanyuan，SHEN Xuxing，CHEN Lijuan *
Department of Hematology，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：To examine the impact of venous thromboembolism（VTE）on the prognosis of newly diagnosed multiple
myeloma（MM）patients treated with immunomodulatory drugs（IMiDs），and to analyze the risk factors. To compare the predictive
efficacy of thrombosis risk assessment scores in VTE in MM patients. Methods：A retrospective examination was conducted on the
clinical data of newly diagnosed MM patients treated with ImiDs at the Department of Hematology，the First Affiliated Hospital of
Nanjing Medical University，from January 2016 to October 2020. The correlation between VTE and the prognosis of MM patients was
analyzed. The VTE risk of patients was quantitatively assessed with Padua，SAVED and IMPEDE scores. The predictive value of the
three thrombotic assessment scales for VTE occurrence in newly diagnosed MM patients was compared using receiver operating
characteristic（ROC）curves and the area under the curve（AUC）. Results：A total of 221 patients newly diagnosed MM patients were
included in this study，with a VTE incidence of 15.8%. Among VTE patients，those aged over 75，with central venous catheterization
（CVC），recent surgery，braking on the bed，extramedullary disease，anthracycline using，autoimmune disease，and hypoalbuminemia
had higher incidence rate. Age over 75 years，CVC，autoimmune disease，and hypoalbuminemia were identified as independent risk
factors for VTE occurrence in MM patients. In terms of predicting VTE formation in newly diagnosed MM patients，the IMPEDE score
demonstrated better efficacy than the other two scoring systems. Conclusion：Age over 75 years，CVC，autoimmune disease，and
hypoalbuminemia are independent risk factors for VTE，and the IMPEDE score has superior predictive efficacy.
［Key words］ venous thromboembolism；multiple myeloma；thrombosis risk assessment；prognosis
［J Nanjing Med Univ，2025，45（05）：665⁃670］
［基金项目］ 国家自然科学基金（82370205）
通信作者（Corresponding author），E⁃mail：chenljb@126.com（ORCID：0000⁃0002⁃6497⁃1194）
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