肿瘤相关性贫血的治疗  

Treatment of cancer-related anemia

作　　者：李昱瑛[1] 方玉[2] 李薇[1] LI Yu-ying;FANG Yu;LI Wei(Department of Hematology,Cancer Center,The First Hospital of Jilin University,Changchun 130021,Jilin,China;Department of Nutrition,Key Laboratory of Carcinogenesis and Translational Research,PekIing University Cancer Hospital&Institute,Beijing 100142,China)

机构地区：[1]吉林大学第一医院肿瘤中心,长春130021 [2]北京大学肿瘤医院暨北京市肿瘤防治研究所营养科,北京100142

出　　处：《肿瘤代谢与营养电子杂志》2018年第3期320-323,共4页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：国家自然科学基金(81670143)

摘　　要：肿瘤相关性贫血是肿瘤相关性炎症或肿瘤相关治疗导致骨髓抑制(主要是放、化疗)引起的贫血。肿瘤相关性贫血可以发生在肿瘤诊治的任何阶段,其发生与肿瘤类型、分期及治疗等因素密切相关。2012年国内的调查显示,肿瘤相关性贫血的发生率为60.83%,其中轻度贫血40.84%,中度贫血15.67%,重度贫血3.47%,极重度贫血0.84%。发病率较高的肿瘤分别为消化道癌、乳腺癌和肺癌等。研究显示,肿瘤相关性贫血会明显降低肿瘤患者的生活质量,影响治疗效果,缩短生存期,增加死亡风险;而通过合理的治疗,纠正贫血后,可以改善患者的生活质量,提高生存率。肿瘤相关性贫血的发病机制复杂,可能与肿瘤本身及其并发症(如肿瘤侵犯骨髓、溶血、失血、肿瘤相关性炎症等)、治疗手段引起的骨髓抑制(化疗、放疗等)等有关。肿瘤相关性贫血的治疗目标为"提高生活质量,降低红细胞输注需求"。在病因治疗的基础上,补充造血原料(铁剂、叶酸、维生素B12等),应用促红细胞生成素类药物及输红细胞治疗为其常用治疗手段。Cancer-related anemia(CRA)is a kind of anemia caused by tumor-associated inflammation or tumor-related treatment that leads to myelosuppression(mainly radiotherapy and chemotherapy).Its frequency and severity depend on tumor type,tumor stage,duration of disease,and treatment status.The incidence of cancer-related anemia in China is 60.83%of which mild anemia 40.84%,moderate anemia 15.67%,severe anemia 3.47%,extremely severe anemia 0.84%.The higher morbidity of the tumor is gastrointestinal cancer,breast cancer and lung cancer.Cancer-related anemia adversely affects quality of life and is associated with reduced overall survival.The correction of anemia in cancer patients has the potential to improve treatment efficacy and increase survival.The pathogenesis of cancer-related anemia is multifactorial,and can be a direct result of cancer invasion(blood loss,marrow infiltration,hemolytic anemia,inflammation),or its treatment(radiotherapy and chemotherapy).Treatment should correct etiologic factors,whenever possible.Symptomatic treatments are red blood cell transfusions,administration of erythropoiesis-stimulating agents and materials for hematopoiesis(iron,folic acid and Vitamin B12).

关 键 词：肿瘤相关性贫血 促红细胞生成素 慢性病性贫血 造血原料 

分 类 号：R730.5[医药卫生—肿瘤] R556[医药卫生—临床医学]