化疗所致粒细胞缺乏患者死亡的危险因素初步探讨.pdf

现代肿瘤医学2014年7月第22卷第7期 MODERN ONCOLOGY,Jul.2014,VOL.22,NO.07
?1651?
化疗所致粒细胞缺乏患者死亡的危险因素初步探讨
邱国超,高建飞,饶智国
Preliminary study for risk factors of death in patients With chemotherapy-induced agran
ulocytosis
g
Department of clog whan General Hospital, Guangzhou Militry Region, Hebei Wuhan 430070, Chin
(Abstract) Objective: To explore risk factors of death in patients with chemotherapy-induced agranulocytosis
Methods: All 60 cancer patients with chemotherapy-induced agranulocytosis were compared between the death group
(case group which had 10 patients and the cure group(control group )which had 50 patients. The data were ana
lyzed on risk factors by univariate analysis and multivariate non-conditional Logistic regression analysis. Results: PS
score >2 when agranulocytosis appeared, complicated with hypertension, coronary heart disease or diabetes, complicat
ed with I -V grades symptoms of digestive side-effects, lowest neutrophil value <0. 1 x 10/L after granulocy
is appeared, and bad appetite when agranulocytosis appeared were risk factors of death in patients with agranulocyto
sis by univariate test analysis Multivariate Logistic regression analysis showed that PS score when agranulocytosis ap-
peared, and whether complicated with hypertension, coronary heart disease or diabetes were statistically significant, the
P values were 0.000 and 0.044 respectively. Conclusion: PS score >2 when agranulocytosis appeared, complicated
with hypertension, coronary heart disease or diabetes are independent risk factors in patients with chemotherapy-in-
duced agranulocytosis
f Key words) chemotherapy; agranulocytosis; death; risk factors
Modern Oncology2014,22(07):1651-1653
摘要】目的:探讨化疗所致粒细胞缺乏症患者死亡的危险因素。方法:60例肿瘤患者中因化疗导致粒细胞
缺乏后死亡的10例患者为病例组,粒细胞缺乏后治愈的50例患者为对照组,对相关因素进行单因素及多因
素非条件 Logistic I回归分析。结果:单因素分析显示粒细胞缺乏发现时 ECOG PS评分>2分,合并高血压、冠
心病或糖尿病,合并Ⅲ-Ⅳ度消化道反应,粒细胞缺乏后最低中性粒细胞<0.1×10/L以及粒细胞缺乏时食
欲差是粒细胞铗乏症患者死亡的危险因素。多因素分析显示,粒细胞缺乏发现时PS评分以及是否合并高血
压、冠心病或糖尿病有统计学意义(P值分别是0.000、0.044)。结论:粒细胞缺乏发现时PS>2分,合并高血
压、冠心病或糖尿病是粒细胞缺乏症患者死亡的独立危险因素。
关键词)化疗;粒细胞缺乏症;死亡;危险因素
【中图分类号】R730.53【文献标识码)ADOI:10.3969/j.1isa.1672-4992.2014.07,52
【文章编号1672-4992-(2014)07-1651-03
化疗是治疗恶性肿瘤的一种重要手段,但化疗在杀伤肿粒缺的特点,旨在探讨粒缺患者死亡的危险因素,为临床治
瘤细胞的同时,也将正常组织细胞一同杀灭,从而产生不良疗这类患者、降低死亡率提供参考依据。
反应。骨髓抑制尤其是粒细胞缺乏症(以下简称为粒缺)是1资料与方法
化疗最重要的不良反应之一,是化疗导致死亡的常见原1.1临床资料
因。本研究回顾性分析近5年本院肿瘤患者化疗后出现
选择2008年11月-2013年04月在我院肿瘤科因化疗
导致粒缺的60例统计资料完整的患者(均统计第1次因化
疗出现粒缺的患者),其中因粒缺死亡的10例为病例组,粒
收稿日期】2013-10-15
缺后治愈的50例为对照组。其中男性44例,占73.3%,女
修回日期】2013-10-20
性16例,占26.7%。年龄最大84岁,最小17岁,平均年龄
【作者单位】广州军区武汉总医院脚瘤科,湖北式汉430070
(60.4±10.5)岁。其中非小细胞肺癌11例,胃癌11例,鼻
に作者筒介)」邸国超(1983-)男,湖北武汉人,士,主治医帅,主晒癌7例,小细胞肺癌5例,恶性淋巴瘤5例,乳腺癌5例,食
要从事肿瘤的临床研究。E-mail:huqiu@163.com
管癌4例,其他12例。其中I、Ⅱ期(包括小细胞肺癌局限
通讯作者】烧智国(1965-),男,湖北成宁人,博士,副主任医师,
期)12例,Ⅲ、Ⅳ期(包括小细胞肺癌广泛期)48例。全部患
主要从事肿瘤基础和临床研究。E-mail: haozhi
者均经细胞学或病理学检査确诊。粒细胞缺乏定义为外周
u02012@163.com