老年急性白血病初治患者放弃化疗状况及相关因素分析

Study on the condition of giving up the initial chemotherapy and its related factors in the elderly with acute leukemia

目的通过分析老年急性白血病初治患者放弃化疗状况及其相关因素，为临床提高患者的化疗依从性提供依据与方向。方法回顾性收集2004—2008年在某三甲医院住院、符合急性白血病诊断标准的老年初治患者183例，随机抽取同期住院的中青年急性白血病患者183例作为对照组，统计放弃化疗原因，分析其相关因素。结果183例老年组患者放弃化疗率50.27%，中青年组为37.7%，2组比较差异有统计学意义（χ^2=5.87，P〈0.05）；放弃治疗的92例老年患者中，48.91%确诊后未接受化疗，42.39%于第1疗程中放弃化疗；老年患者放弃化疗的主要原因有病情危重，经济困难，耐受性差；而中青年组因经济困难放弃治疗居首位；年龄≥75岁组患者放弃化疗率高于60～74岁组，差异有统计学意义（P〈0.05）。结论老年白血病初治患者放弃化疗率高，病情危重、经济困难、耐受力差及年龄大是放弃化疗的主要原因。

Objective To study on the condition of giving up the initial chemotherapy and its related factors in the elderly with actue leukemia（AL）. Methods A total of 183 elderly patients diagnosed of AL were selected from a university hospital from 2004 to 2008 by reviewing the records of the patients. While, 183 youth patients with AL were randomly sampled for control group. Results （1）The rate （92 eases , accounts 50.27% ） of giving up the initial chemotherapy in the elderly was higher than that of the youth patients （69 eases, accounts 37.7% ）, and the statistics difference was significance （x^2 = 5.87, P 〈 0. 05）. （2） 48.91% of the old patients had not accepted the initial chemotherapy, and 42.39% gave up their initial chemotherapy at the first course. （3） The main factors contributing to patients＇ giving up their initial chemotherapy were patients＇ severe conditons （ accounted for 42.38% ）, the economy difficult （ accounted for 36.96% ） and the low tolerance （ accounted for 11.96% ）. But the economical difficult （66.67%） was at the first place in the youth group. （4）The old patients over 75 had a higher rate of quitting chemotherapy. Conclusions The rate of giving up the chemotherapy in the elderly patients is high. Patients＇ severe condition, economic, the low tolerance and old age are the main factors.