肿瘤抗血管生成药物致高血压的临床分析

Clinical study of hypertension-induced by tumor anti-angiogenesis drugs

目的：分析抗血管生成药物治疗肿瘤高血压发生的规律及其高危因素。方法：回顾分析自2009年6月至2013年12月在我院应用抗血管生成治疗的恶性肿瘤患者160例,包括患者一般情况,如年龄、性别、身高、体重等,及症状体征、肿瘤类型、治疗方案、ECOG及既往病史。结果：160患者年龄16~86岁,平均年龄（46.5±16.5）岁,男性共132例,女性28例,共有42例发生高血压,其中Ⅰ级6例,占14.28%,Ⅱ级15例,占35.72%,Ⅲ级21例,占50.00%,无高血压危象发生,经药物控制后血压稳定率100%。单因素分析,发现年龄、既往高血压病史及肿瘤类型与抗血管生成药物致高血压有关（P〈0.05）,而性别、药物类型和ECOG评分均与抗血管生成药物致高血压无关（P〉0.05）。多因素Logistic分析,年龄（OR=2.850,95%CI：1.173~6.925）及既往高血压（OR=5.483,95%CI：2.945~10.209）为抗血管生成药物致高血压的独立危险因素（P〈0.05）。结论：抗血管生成药物治疗肿瘤,高血压发生率较高,以中度为主,药物控制良好,既往高血压史、肾癌等是抗血管生成药物致高血压的危险因素。

Objective： To study risk factors of hypertension causted by tumor anti- angiogenesis therapy. Methods： To analyze data of 160 malignant tumors patients treated by anti- angiogenic therapy. Results： In 160 patients,the age was 16 ~ 86 years,mean age（ 46. 5 ± 16. 5） years,132 male,female 28. There were 42 cases of hypertension,grade Ⅰ 6 cases（ 14. 28%）,Ⅱ grade 15 cases（ 35. 72%）,grade Ⅲ 21 cases（ 50. 00%）. Non- hypertensive crisis occurred after the drug to control blood pressure stabilized rate was 100%. Age,previous history of hypertension and tumor type and anti- angiogenesis were related with drug- induced hypertension（ P〈0. 05）,but gender,drug type and ECOG performance status were not associated with antiangiogenic drug- induced hypertension unrelated（ P〈0. 05）. Logistic regression analysis showed age（ OR = 2. 850,95% CI： 1. 173 ~ 6. 925） and previous hypertension（ OR = 5. 483,95% CI： 2. 945 ~ 10. 209） for anti- angiogenic independent risk factors for drug- induced hypertension（ P〈0. 05）. Conclusion： Antiangiogenic cancer therapy can induce higher incidence of hypertension. Previous history of hypertension,kidney and other anti- angiogenic drug- induced hypertension are risk factors.