化疗后骨髓抑制危险因素分析

Chemotherapy-Induced Myelosuppression: Clinical Analysis of Risk Factors

目的探讨化疗后骨髓抑制的相关危险因素。方法对118例实体瘤化疗患者所具有的可能与骨髓抑制相关的危险因素进行单因素分析,单因素分析中有意义的因素(P<0.05)进行多因素分析。结果单因素分析:A组肝、肾功能异常明显高于B组(P<0.05),A组曾接受放疗≥3次明显高于B组(P<0.05),A组曾接受化疗≥6次明显高于B组(P<0.05),A组年龄≥60岁明显高于B组(P<0.05)。多因素分析:高剂量化疗(OR14.13,P<0.01,参数估计2.58),高毒性化疗药的应用(OR8.86,P<0.01,参数估计2.01),KPS评分≤60(OR5.11,P<0.01,参数估计0.71),骨或骨髓转移(OR3.16,P<0.01,参数估计1.37),化疗前白细胞水平低(OR7.56,P<0.01,参数估计0.416)。结论高剂量化疗药及高毒性化疗药的应用、KPS评分≤60、骨转移、化疗前白细胞水平低,年龄、肝肾功能情况及肿瘤分期、以往有无接受化疗均与化疗后骨髓抑制相关。

Objective To analyze the risk factors of sever mylosuppression.Methods The potential risk factor related to myelosuppression was managed by univiriate analysis in 118 patients with cancers who received chemotherapy.The factors which had significance(P<0.05)were selected to be done by Logistic regression analysis.Results In univiriate analysis, the rate of hepatic and renal failure in group A was much higher than that in group B(P<0.05).The myelosuppression rate in patients receiving radiotherapy or chemotherapy was higher than that in group B(P<0.05).In multiviriate analysis,the rate in large dose of chemotherapy was significantely increased than that in group B(parameter estimation 2.58,OR14.13,P<0.01).cytotoxic drugs,types of the chemotherapy drugs(OR(8.86),P<0.01,parameter estimation 2.01).KPS score≤60, and metastasis of the bone or bone marrow(OR 3.16,P<0.01,parameter estimation 1.37).These three factors had no significance The important risk factors of chemotherapy Conclusion The model can predictivly judge the probability of sever mylosuppression after chemotherapy.Then it can instruct the prophylactic growth factor administration.