关键词:

 , 急性移植物抗宿主病 , 骨髓增生 , 干细胞移植 , 模型构建 , 护理

Abstract:

Objective To explore the early warning model of acute graft-versus-host disease（aGVHD）after haplotype hematopoietic stem cell transplantation in adult myelodysplastic syndrome（MDS）. Methods The clinical data of 50 adult MDS patients who received haplotype hematopoietic stem cell transplantation at the Second Affiliated Hospital of Air Force Medical University from January 2021 to January 2023 were included. Patients with acute graft-versus-host disease after treatment were included in the occurrence group，and patients withoutacute graft-versus-host disease were included in the non-occurrence group. The clinical data of patients were collected and analyzed，the influencing factors of acute graft-versus-host disease after haplotype hematopoietic stem cell transplantation were determined by Logistic regression analysis，and the nomogram early warning model was constructed by using the determined independent influencing factors，and the effectiveness of the nomogramprediction model for acute graft-versus-host disease after haplotype hematopoietic stem cell transplantation wasevaluated. Results Fifty adult MDS patients received haplotype hematopoietic stem cell transplantation in our hospital. The incidence of patients with acute graft-versus-host disease was 30%，while the proportion of patientswithout acute graft-versus-host disease was 70%. Logistic regression analysis showed that donor sex，race and C- reactive protein were the risk factors for acute graft-versus-host disease（OR ＞ 1，P ＜ 0.05），while uric acid was the protective factor for acute graft-versus-host disease（OR ＜ 1，P ＜ 0.05）in adult MDS patients after haplotype hematopoietic stem cell transplantation. ROC curve was drawn with certain independent influencing factors，and the results showed that the AUC values of donor's sex，race，uric acid and C- reactive protein were all above 0.60，which indicated that the above indexes provided value for early warning of acute graft-versus-host disease afterhaplotype hematopoietic stem cell transplantation. Using the above independent influencing factors，a nomogram earlywarning model was constructed，and the value obtained by adding the scores of risk factors was the probability of acute graft-versus-host disease after haplotype hematopoietic stem cell transplantation. The verification results showed that the C-index value of the calibration curve was 0.846，which indicated that the nomogram prediction model had good prediction energy efficiency. Conclusion The nomogram constructed by influencing factors of acute graft-versus-host disease after haplotype hematopoietic stem cell transplantation can predict the incidence of this disease，specific treatment and nursing should be carried out according to gender，race and C-reactive protein to reduce the risk of acute graft-versus-host disease. 

Key words:

Acute graft-versus-host disease , Myelodysplasia , Stem cell transplantation , Modelconstruction, Nurse