中国肿瘤相关性贫血发生率及治疗现状的流行病学调查研究

Prevalence and Treatment of Cancer-related Anemia:A Nationwide Survey in China

[目的]调查中国恶性肿瘤患者的贫血发生率及贫血治疗状况。[方法]对全国97家医院成年恶性肿瘤患者进行开放性、多中心、单次探访、非干预性的横断面调查。通过回顾患者病史,填写贫血调查表格,收集相关数据,如肿瘤类型、疾病分期、肿瘤治疗情况等。根据美国国立癌症研究所(NCI)的贫血分级标准将血红蛋白水平分为5级,以评估贫血的严重程度。[结果]共纳入来自全国97家医院的7324例有效病例,患者平均血红蛋白(Hb)为(114.36±19.60)g/L,贫血发生率为49.24%(3606/7324),其中1级贫血28.84%,2级贫血15.91%,3级贫血3.66%,4级贫血0.83%。不同肿瘤类型中,泌尿系统肿瘤伴贫血发生率最高(62.89%),其次是妇科肿瘤(60.32%)和胃肠道肿瘤(51.13%)。在贫血患者中,高达92.84%未给予任何纠正贫血的措施和治疗;接受贫血治疗的患者中,促红细胞生成素(EPO)治疗的比例为44.96%,输血治疗的比例为31.39%,铁剂治疗的比例为6.59%。[结论]目前国内肿瘤相关性贫血发生率较高,但相应的贫血治疗率极低,应加强肿瘤患者的贫血管理。

[Purpose]To investigate the prevalence and treatment of cancer-related anemia(CRA)in China.[Methods]An open-ended,multi-center,single-visit,non-interventional,cross-sectional study about CRA was undertaken in 97 hospitals in China during April to July 2012.[Results]A total of 7324 evaluable patients were recruited from 97 hospitals in China.Median hemoglobin(Hb)of all patients was(114.36±19.60)g/L.CRA occurred in 3606 patients(49.24%),including 2112 cases of mild anemia(28.84%),1165 cases of moderate anemia(15.91%),268 cases of severe anemia(3.66%),and 61 cases of life-threatening anemia(0.83%).Patients with urogenital cancer had the highest rate of CRA(62.89%),followed by patients with gynecological(60.32%)and gastrointestinal cancers(51.13%).As high as 92.84%of the patients with CRA did not receive any anemia treatment.Of the 258 patients with CRA who did receive anemia treatment,44.96%received erythropoietin(EPO),31.39%had a blood transfusion,6.59%had iron supplement.[Conclusion]The survey demonstrates that CRA is frequently observed in Chinese cancer patients,and a large amount of patients do not receive treatment for anemia,suggesting that CRA management must be improved among cancer patients.