中青年急性白血病患者化疗后发生出血事件的影响因素

Influencing factors of bleeding events in young and middle-aged patients with acute leukemia after chemotherapy

目的:分析中青年急性白血病(AL)患者化疗后发生出血事件的影响因素。方法:回顾性分析2018年4月至2022年5月于该院化疗的195例中青年AL患者的临床资料,根据化疗后是否发生出血事件将患者分为出血组61例和未出血组134例。收集并比较两组临床资料,采用多因素Logistic回归分析患者化疗后发生出血事件的影响因素。结果:两组性别、年龄、BMI、高血压、糖尿病、吸烟、饮酒、AL类型、化疗次数、留置导尿管情况及血清白蛋白水平比较,差异均无统计学意义(P>0.05);出血组经常熬夜、合并感染、长时间粒细胞缺乏占比均高于未出血组,纤维蛋白原水平、血小板计数均低于未出血组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,经常熬夜、合并感染、长时间粒细胞缺乏均是中青年AL患者化疗后发生出血事件的危险因素(OR>1,P<0.05),高水平纤维蛋白原、血小板计数均是中青年AL患者化疗后发生出血事件的保护因素(OR<1,P<0.05)。结论:经常熬夜、合并感染、长时间粒细胞缺乏均是中青年AL患者化疗后发生出血事件的危险因素,高水平纤维蛋白原、血小板计数均是中青年AL患者化疗后发生出血事件的保护因素。

Objective:To analyze influencing factors of bleeding events in young and middle-aged patients with acute leukemia(AL) after chemotherapy.Methods:The clinical data of 195 young and middle-aged AL patients who received chemotherapy in the hospital from April 2018 to May 2022 were retrospectively analyzed.According to whether bleeding events occurred after chemotherapy,these patients were divided into bleeding group(61 cases) and non-bleeding group(134 cases).The clinical data of the two groups were collected and compared.Multivariate Logistic regression analysis was used to analyze the influencing factors of bleeding events in the patients after chemotherapy.Results:There were no significant differences in gender,age,BMI,hypertension,diabetes,smoking,drinking,AL type,number of chemotherapy,indwelling catheter and serum albumin level between the two groups(P<0.05).The proportions of frequent staying up late,combined infection and days of long-term granulocyte deficiency in the bleeding group were higher than those in the non-bleeding group;the fibrinogen level and the platelet count were lower than those in the non-bleeding group;and the differences were statistically significant(P<0.05).The multivariate logistic regression analysis showed that frequent staying up late,combined infection and days of long-term granulocyte deficiency were all risk factors for the bleeding events in the young and middle-aged patients with AL after chemotherapy(OR1,P<0.05);while high levels of fibrinogen and platelet count were the protective factors(OR<1,P<0.05).Conclusions:Frequent staying up late,combined infection and days of long-term granulocyte deficiency are the risk factors for the bleeding events in the young and middle-aged patients with AL after chemotherapy,while high levels of fibrinogen and platelet count are the protective factors.