蒽环类在治疗急性白血病中导致尿酸升高的相关性分析

A Study of Correlation between Anthracycline and Uric Acid in the Treatment of Acute Leukemia

目的通过探究蒽环类药物在治疗急性白血病中导致尿酸升高的相关性及影响因素,为患者安全、有效、经济地选择药物提供参考。方法选取某院2017年1月1日～2017年12月31日诊断为急性白血病并入院治疗的患者240例作为研究对象,采用随机数字表法在出现血尿酸升高的患者中抽取120名为实验组;采取1∶1的比例进行匹配,采用随机数字表法在未发生血尿酸升高的患者中随机抽取120名患者为对照组。通过病例对照研究,对患者基本情况、用药相关信息进行回归分析寻找相关性。结果实验组中57.5%的患者应用了蒽环类药物,而对照组中仅23.3%的患者应用了蒽环类药物。在所有应用蒽环类药物的患者中有71.1%出现血尿酸升高,OR值为4.45 [2.55,7.76]。单因素分析结果显示,患者的年龄(f=0.047)、血红蛋白计数(f=0.028)、肝功能(f=0.017)、肾功能(f=0.046)以及给药剂量(f=0.012)与尿酸的升高均具有相关性。结论应用蒽环类药物的患者发生血尿酸升高的几率显著增加,与患者的年龄、血红蛋白水平、肝肾功能及给药剂量均相关,在临床应用中需密切监护该类不良反应,一旦出现及时给予对症治疗。

OBJECTIVE To provide a reference for safe, effective and economical selection of drugs for patients by exploring the correlation and influencing factors of anthracycline resulting in elevated uric acid in the treatment of acute leukemia. METHODS A total of 240 patients diagnosed with acute leukemia and admitted to hospital from January 1,2017 to December 31, 2017 were selected. A random number table method was used to extract 120 patients as experimental group from patients with elevated serum uric acid and 120 patients as control group from patients without elevated serum uric acid, and the ratio was 1:1. Through the case-control study, the correlation was found by regression analysis for the basic situation of patients and drug related information. RESULTS A total of 57.5% of the patients in the experimental group applied anthracyclines, while only 23.3% in the control group. In all patients treated with anthracycline, 71.1% had elevated serum uric acid, OR=4.45[2.55, 7.76]. Single factor analysis showed that the increase of uric acid was associated with the age (f=0.047), hemoglobin count (f=0.028), liver function (f=0.017), renal function (f=0.046), and administration dosage (f=0.012) of the patients. CONCLUSION The incidence of elevated serum uric acid in patients with anthracycline is significantly increased, which is associated with the age, hemoglobin count, liver function, renal function, and administration dosage of the patients. This kind of adverse reaction should be monitored closely in clinical application, and should be given symptomatic treatment in time.