老年恶性血液病患者化疗后急性心力衰竭的危险因素  

Risk factors influencing acute heart failure after chemotherapy in elderly patients with hematological malignancy

作　　者：陈侠[1] 闫昱江[1] 王红[1] 张红鸽 CHEN Xia;YAN Yu-fiang;WANG Hong;ZHANG Hong-ge(Department of Hematology,Second Affiliated Hospital of Shaanxi University of Traditional Chinese Med-icine,Xianyang 712000,China;Department of Cardiology,Second Affiliated Hospital of Shaanxi Univer-sity of Traditional Chinese Medicine.Xianvan,712000,Chins)

机构地区：[1]陕西中医药大学第二附属医院血液病科,咸阳712000 [2]陕西中医药大学第二附属医院心血管内科,咸阳712000

出　　处：《中国肿瘤临床与康复》2018年第10期1266-1269,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨老年恶性血液病患者化疗治疗后并发急性心力衰竭的危险因素。方法选取2015年1月至2018年1月间陕西中医药大学第二附属医院收治的161例老年恶性血液病患者进行回顾性分析,将化疗治疗后并发急性心力衰竭的30例患者纳入研究组,化疗治疗后未并发急性心力衰竭的131例患者纳入对照组。分析两组患者的病例资料,对可能引起老年恶性血液病患者化疗后并发急性心衰的危险因素进行单因素和Logistic多因素分析。结果单因素分析结果显示,两组患者心脏病史、粒细胞缺乏、脓毒血症/感染性休克、血红蛋白水平及液体平衡量比较,差异均有统计学意义(均P<0.05);两组患者性别、呼吸衰竭、肾功能不全和化疗总疗程比较,差异无统计学意义(P>0.05)。Logistic多因素分析结果指出,患者的血红蛋白水平、化疗后平均液体平衡量及是否伴有脓毒血症/感染性休克是引起老年恶性血液病患者化疗后并发急性心衰的危险因素。结论患者血红蛋白水平、化疗后平均液体平衡量及是否伴有脓毒血症/感染性休克为并发急性心力衰竭的独立危险因素。Objective To investigate the risk factors influencing acute heart failure in elderly patients with hematological malignancies after chemotherapy. Methods We retrospectively analyzed the clinical treatment data of 161 elderly patients with hematologic malignancies treated at Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from January 2015 to January 2018. Among them,30 patients who had acute heart failure after chemotherapy were included in the study group and 131 patients without acute heart failure after chemotherapy were included in the control group. The clinical data were analyzed in both groups. Univariate and multivariate analysis were carried out to investigate risk factors for acute heart failure after chemotherapy in elderly patients with hematologic malignancies. Results The results of univariate analysis showed there were significant differences in history of heart disease,agranulocytosis,sepsis/infectious shock,hemoglobin level,and fluid balance between the two groups（ all P〉0. 05）.However,there was no significant difference in gender,respiratory failure,renal insufficiency,and total course of chemotherapy between the two groups（ all P〈0. 05）. Logistic multivariate analysis showed that hemoglobin levels,average fluid balance after chemotherapy,and complication of sepsis/infectious shock were risk factors influencing acute heart failure in elderly patients with hematological malignancies after chemotherapy（ all P〈0. 05）. Conclusion Patients＇ hemoglobin levels,mean fluid balance after chemotherapy,and complication of sepsis/septic shock are independent risk factors for acute heart failure.

关 键 词：恶性血液病 药物疗法 急性心力衰竭 危险因素 

分 类 号：R733[医药卫生—肿瘤]