胃癌根治术后辅助化疗期间血红蛋白下降的相关因素分析  

Analysis of related factors of postgastrectomy hemoglobin decline in adjuvant chemotherapy

作　　者：钱小军 陈健[1] 潘跃银 王刚[1] 孙玉蓓 陈曼萍 郑海燕 QIAN Xiaojun;CHEN Jian;PAN Yueyin;WANG Gang;SUN Yubei;CHEN Manping;ZHENG Haiyan(Department of Oncology,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei,Anhui 230001,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)肿瘤内科,安徽合肥230001

出　　处：《安徽医药》2020年第8期1525-1529,共5页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省自然科学基金(1608085QH190);“科大新医学”联合基金(WK9110000009,WK9110000067)。

摘　　要：目的分析胃癌根治术后接受辅助化疗期间,病人血红蛋白下降的影响因素。方法收集中国科学技术大学附属第一医院2015年1月至2017年1月接受铂类/紫杉类联合氟脲嘧啶类方案辅助化疗的102例胃癌病人的资料,分析病人临床病理特征与辅助化疗期间血红蛋白下降的相关性。结果 64例(62.7%)病人术后存在贫血,79例(77.4%)病人辅助化疗期间存在贫血。接受辅助化疗的病人中,70例(68.6%)血红蛋白下降1 mg/L及以上,17例(16.6%)发生Ⅲ~Ⅳ级化疗不良反应,7例(6.8%)因不良反应调整化疗剂量及方案。单因素分析结果显示,肿瘤浸润深度为T4的病人血红蛋白下降至少1 mg/L以及2 mg/L的发生率明显高于T1-3的病人(P<0.05)。多因素分析结果显示,术中出血量>100 mL、化疗前存在贫血、白蛋白低于正常值的病人,血红蛋白下降1 mg/L及以上的发生率明显高于对照组(P<0.05)。结论胃癌根治术后T4、术中出血大于100 mL、化疗前贫血、低蛋白血症是影响辅助化疗引起血红蛋白下降的高危因素。Objective To explore the influencing factors of hemoglobin decline during adjuvant chemotherapy after radical gastrectomy.Methods One hundred and two gastric cancer patients who received adjuvant chemotherapy with platinum or paclitaxel with fluorouracil regimen from January 2015 to January 2017 in the First Hospital of University of Science and Technology of China were collected,and the correlation between the clinical pathological characteristics and adjuvant chemotherapy were analyzed.Results Among them,64 patients(62.7%)had anemia after surgery,79 patients(77.4%)had anemia during chemotherapy.Among the patients who received adjuvant chemotherapy,70 patients(68.6%)had a further decrease in hemoglobin at least 1 mg/L,17 patients(16.6%)developed grade Ⅲ-Ⅳ adverse reactions,and 7 patients(6.8%)had the chemotherapy dose or regimena djustment due to adverse reactions.Univariate analysis revealed that hemoglobin in patients with stage T4 tumor decreased by at least 1 mg/L or 2 mg/L and the incidence was significantly higher than that in patients with T1-3(P<0.05).Multivariate analysis revealed that patients with more than 100 mL operational bleeding,pre-chemotherapy anemia,albumin below normal,and the incidence of hemoglobin reduction of at least 1 mg/L,the incidence was significantly higher than those of control group(P<0.05).Conclusion Gastric cancer patients with stage T4,more than 100 mL operational bleeding,pre-chemotherapy anemiaor hypoproteinemia are highrisk factors that affect the decrease in hemoglobin caused by adjuvant chemotherapy.

关 键 词：贫血 低色素性 胃肿瘤 胃切除术后综合征 辅助化疗 高危因素 

分 类 号：R735.2[医药卫生—肿瘤]