抗肿瘤血管生成药物致高血压的临床观察  

Clinical Observation and Study of Anti-angiogenesis Drugs Induced Hypertension

作　　者：王娟[1] 缪雄[1] 刘锟[2] 

机构地区：[1]江苏省海安人民医院,226600 [2]南通大学附属医院,226600

出　　处：《实用癌症杂志》2017年第2期227-230,共4页The Practical Journal of Cancer

基　　金：江苏省"六大人才高峰"高层次人才选拔培养资助项目(编号:YY-006)

摘　　要：目的探讨肿瘤患者在进行抗肿瘤血管生成治疗的过程中高血压发生率及处理方式,研究影响患者高血压发生的因素。方法随机选取抗肿瘤血管生成治疗的患者180例,按性别分成2组。抗肿瘤血管生成常见治疗药物:和化疗联合的贝伐单抗,进行单药治疗的索拉非尼、依维莫司、阿昔替尼、舒尼替尼。观察治疗过程中患者高血压发生情况,使用NCI-CTC AE 3.0,把它作为评估患者高血压程度的依据,根据不同级别采取相应的降压治疗措施。最后采用Logistic多元回归分析和单因素分析的方法,分析影响高血压发生的因素。结果 180例恶性肿瘤患者在行抗肿瘤血管生成药物治疗的过程中,高血压的发生率为30%,Ⅲ级发生率为46%。经相应的降压治疗措施后血压均恢复稳定,避免了高压危象的出现。经记录发现患者发生高血压的首次中位时间最早为5.0天,发生重度高血压的中位时间最早为12.0天。既往有高血压史患者及肾癌患者发生高血压的风险要远远高于无既往高血压患者及其他类型的恶性肿瘤患者,其差异具有统计学意义(P<0.05)。结论抗肿瘤血管生成药物致恶性肿瘤患者高血压的出现率较高。对中度高血压,采用降压药物治疗效果较为显著。Objective To investigate the incidence and influence factors of hypertension during anti -angiogenesis thera-py for tumor patients .Methods 180 patients were randomly selected and equally divided by sex into 2 groups.Common anti-an-giogenesis drugs：chemotherapy and bevacizumab ,monotherapy sorafenib,everolimus,abciximab imatinib,sunitinib.Observe the course of treatment in patients with hypertension ,the use of NCI-CTC AE 3.0,use it as the basis to assess the severity of hyper-tension patients ,to take appropriate measures in accordance with different levels of antihypertensive therapy .Finally,the method of logistic regression analysis and single factor analysis ,the study assessed the factors causing hypertension .Results 80 cases of patients with malignant line anti-angiogenesis drug treatment process , the proportion of hypertension was 30%,Ⅲ grade occur-rence ratio of 46%;antihypertensive treatment after appropriate measures to restore stability in blood pressure , avoid the high pressure crisis appears .After the first record found in patients with a median time to first occurrence of hypertension was 5 days, and the median time to first occurrence of severe hypertension was 12 days.A history of stomach cancer patients and patients with a history of hypertension risk of high blood pressure was much higher than in patients without previous malignancy and hyperten -sion and other types,there had statistically significant differences （P〈0.05）.Conclusion Anti-angiogenesis drugs cause a high-er rate of occurrence of hypertension for malignant tumors patients ,antihypertensive drug treatment has significant effect on hyper-tension and moderate hypertension .

关 键 词：恶性肿瘤 抗血管生成药物 高血压 

分 类 号：R730.6[医药卫生—肿瘤]