卵巢癌化疗患者凝血状态观察及影响因素分析

Observation of coagulation status and analysis of influencing factors in patients with ovarian cancer undergoing chemotherapy

目的观察卵巢癌化疗患者的凝血状态,并探讨其影响因素。方法回顾性分析首都医科大学附属北京妇产医院2018年2月至2022年1月收治的105例卵巢癌化疗患者的临床资料,根据化疗后是否存在高凝状态将患者分为高凝组和非高凝组,探讨高凝状态的发生率及影响因素。结果105例患者中,48例出现了化疗后高凝状态,发生率为45.7%(48/105)。其中2项凝血指标升高为64.6%(31/48),3项凝血指标升高为33.3%(16/48),4项凝血指标升高为2.1%(1/48)。单因素分析显示,年龄、体质量指数、慢性内科合并症数量、化疗后糖类抗原125(CA125)水平、化疗后白细胞水平、肿瘤分期是卵巢癌化疗后高凝状态的潜在影响因素(P<0.05)。多因素Logistic回归分析显示,慢性内科合并症数量(OR=7.152,95%CI:1.991~25.695,P=0.003)和化疗后CA125水平(OR=1.005,95%CI:1.001~1.009,P=0.018)是卵巢癌化疗后高凝状态的独立影响因素。结论血液高凝状态在卵巢癌化疗患者中较为常见,尤其应重视多项慢性内科合并症和化疗后CA125水平较高的患者,应积极地展开相关防治措施。

Objective To observe the blood coagulation state of patients with ovarian cancer undergoing chemotherapy and explore its influencing factors.Methods The clinical data of 105 patients with ovarian cancer treated in Beijing Obstetrics and Gynecology Hospital from February 2018 to January 2022 were analyzed retrospectively.The patients were divided into hypercoagulable group and non-hypercoagulable group according to the existence of hypercoagulable state after chemotherapy.The incidence and influencing factors of hypercoagulable state were explored.Results Of the 105 patients in this study,48 developed post-chemotherapy hypercoagulable status,with an incidence rate of 45.7%(48/105).Two of the coagulation markers were elevated by 64.6%(31/48),three by 33.3%(16/48),and four by 2.1%(1/48).Univariate analysis showed age,body mass index,number of chronic medical comorbidities,carbohydrate antigen 125(CA125)level after chemotherapy,leukocyte level after chemotherapy and tumor stage were potential influencing factors for the hypercoagulable state of ovarian cancer after chemotherapy(P<0.05).Multivariate Logistic regression analysis showed that the number of chronic medical comorbidities and the level of CA125 after chemotherapy were independent influencing factors of hypercoagulable state after chemotherapy for ovarian cancer,and the OR values were 7.152(95%CI:1.991-25.695,P=0.003),1.005(95%CI:1.001-1.009,P=0.018).Conclusion Hypercoagulable state is common in patients with ovarian cancer undergoing chemotherapy.Attention should be paid to patients with multiple chronic medical comorbidities and high CA125 level after chemotherapy,and relevant prevention and treatment measures should be actively carried out.