多发性骨髓瘤患者治疗后发生静脉血栓栓塞的危险因素

Risk factors of postoperative venous thromboembolism in patients with multiple myeloma

目的分析多发性骨髓瘤(multiple myeloma,MM)患者治疗后发生静脉血栓栓塞(venous thromboembolism,VTE)的危险因素。方法收集2012年1月至2022年1月于山西医科大学第一医院血液内科初治的MM患者157例。根据是否发生VTE,将患者分为非VTE组(n=124)和VTE组(n=33)。比较两组临床资料,分析MM患者治疗后发生VTE的危险因素。结果单因素分析显示,MM患者的年龄、近期手术史、近期骨折史、D-二聚体>0.55mg/L、使用免疫调节药物、IMPEDE评分≥8分与MM患者治疗后发生VTE有关(P<0.05);二元多因素Logistic分析显示,MM患者的年龄、近期手术史、D-二聚体>0.55mg/L、使用免疫调节药物是MM患者发生VTE的危险因素。结论评估MM患者治疗后发生VTE的风险需全面结合患者年龄、病史、实验室指标及治疗方案等情况,鉴于国外关于MM患者发生VTE相关评分可能并不完全适用于中国人群,还需进一步研究开发适用于中国MM患者发生VTE的风险评分并加以验证。

Objective To analyze risk factors of postoperative venous thromboembolism(VTE)in multiple myeloma(MM)patients.Methods One hundred and fifty seven MM patients initially treated in the Department of Hematology,the First Hospital of Shanxi Medical University from January 2012 to January 2022 were enrolled.Patients were assigned to the non-VTE group(n=124)and VTE group(n=33)based on the existence of VTE.Clinical data of the two groups were compared,and risk factors for VTE in MM patients after treatment were analyzed.Results The results of univariate analysis showed that the age,recent surgical history,recent fracture history,D-dimer>0.55 mg/L,use of immunomodulatory drugs,and IMPEDE score≥8 points were related to the occurrence of VTE in MM patients after treatment(P<0.05).Binary multivariate logistic analysis showed that the age,recent surgical history,D-dimer>0.55 mg/L,and use of immunomodulatory drugs were the risk factors for the occurrence of VTE in MM patients.Conclusion The assessment of the risk of VTE in MM patients after treatment should be comprehensively combined with the patient's age,medical history,laboratory indicators and treatment plan.In view of the fact that the relevant score for MM patients in foreign countries may not be fully applicable to the Chinese population,further research is needed to develop the risk score for VTE in Chinese MM patients and verify it.