胃癌患者术前贫血临床特点及相关危险因素分析

Clinical Characteristics and Related Risk Factors of Preoperative Anemia in Patients with Gastric Cancer

目的探讨胃癌患者术前贫血的临床特点及危险因素。方法回顾性分析2015年1月~2018年12月于南京医科大学第二附属医院接收胃癌手术的218例胃癌患者的临床资料。根据术前血红蛋白(hemoglobin,Hb)水平将患者分为贫血组(n=84)和无贫血组(n=134)。收集患者性别、年龄、高血压、糖尿病、体重指数(body mass index,BMI)、癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原199(glycogen antigen 199,CA199)、糖类抗原724(glycogen antigen 724,CA724)、肿瘤位置、肿瘤直径、临床分期和淋巴结转移等资料,采用Logistic回归分析评价胃癌患者术前贫血的危险因素。结果218例胃癌患者中,术前贫血发生率为38.53%,其中轻度贫血51例(60.7%)、正常细胞性贫血50例(59.5%)。两组患者的BMI、高血压、糖尿病、CEA、CA199、CA724、肿瘤位置和淋巴结转移情况比较,差异均无统计学意义(P>0.05),两组患者的性别、年龄、肿瘤直径和临床分期情况比较,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,性别(P=0.002)、年龄(P=0.023)、肿瘤直径(P=0.001)和临床分期(P=0.003)是胃癌患者术前贫血的独立影响因素。结论性别、年龄、肿瘤直径和临床分期是胃癌患者术前贫血的独立危险因素,有助于临床医师对患者采取有效的干预策略。

Objective To explore the clinical features and risk factors of preoperative anemia in patients with gastric cancer.Methods The clinical data of 218gastric cancer patients who received gastric cancer surgery in the Second Affiliated Hospital of Nanjing Medical University from January 2015 to December 2018 were retrospectively analyzed.Patients were divided into the anemia group(n=84)and non-anemia group(n=134)based on hemoglobin levels.The gender,age,hypertension,diabetes,body mass index(BMI),carcinoembryonic antigen(CEA),cancer antigen 199(CA199),cancer antigen 724(CA724),tumor location,tumor size,clinical stage and lymph node metastasis were collected.The Logistic regression analysis was performed to analyze the risk factors of preoperative anemia in patients with gastric cancer.Results Among 218 patients with gastric cancer,the incidence of preoperative anemia was 38.53%,including 51 cases(60.7%)of mild anemia and 50 cases(59.5%)of normocytic anemia.There were no statistically significant differences in BMI,hypertension,diabetes,CEA,CA199,CA724,tumor location,and lymph node metastasis between the two groups(P>0.05),while there were statistically significant differences in the terms of gender,age,tumor size,and clinical stage between the two groups(P<0.05).Multivariate Logistic regression analysis showed that gender(P=0.002),age(P=0.023),tumor size(P=0.001),and clinical stage(P=0.003)were independent risk factors for preoperative anemia in patients with gastric cancer.Conclusion Gender,age,tumor size and clinical stage are independent risk factors for preoperative anemia in patients with gastric cancer,which is helpful for clinicians to take some intervention strategies for patients.