老年肿瘤相关静脉血栓栓塞症的临床分析  

Clinical analysis of tumor-related venous thromboembolism in elderly patients

作　　者：王昱[1] 席少枝 郭娜 陶琨[1] 高云[1] 何水波[1] 郁水华[1] 易忠[1] Wang Yu;Xi Shaozhi;Guo Na;Tao Kun;Gao Yun;He Shuibo;Yu Shuihua;Yi Zhong(Department of Geriatrics Aerospace Center Hospital(ASCH),Beijing 100049,China)

机构地区：[1]航天中心医院老年医学一科,北京100049

出　　处：《中华老年医学杂志》2020年第11期1297-1300,共4页Chinese Journal of Geriatrics

摘　　要：目的探究老年肿瘤相关静脉血栓栓塞症患者的临床特点及与患者出现肺栓塞相关的危险因素。方法回顾性纳入2014年6月至2018年11月于我院年龄$65岁、患恶性肿瘤合并深静脉血栓栓塞的患者。收集患者的一般资料、肿瘤原发灶情况、肿瘤转移情况、伴随疾病、发生血栓类型及部位等。计算Charlson共病指数。根据深静脉血栓部位,分为深静脉血栓(DVT)组和肺栓塞(PTE)组,对两组患者的各项指标进行分析肺栓塞的危险因素。结果318例患者中281例(8&4%)为深静脉血栓组,37例(11.6%)为肺栓塞组。两组患者年龄、性别、吸烟史及住院天数方面差异无统计学意义(P>0.05);在原发肿瘤类型及肿瘤转移情况方面差异无统计学意义(P>0.05);主要共病包括:高血压、糖尿病、冠状动脉粥样硬化性心脏病、慢性阻塞性肺病、心力衰竭、脑血管病、慢性肾脏病和慢性肝病发病例数均差异无统计学意义(P>0.05)。在Charlson共病指数方面,肺栓塞组(7.22±3.95)显著高于深静脉血栓组(5.69±2.89)(P=0.028)。Logistic回归分析显示患者年龄(OR=0.9,95%CI:0.846〜0.985,P=0.001)、肿瘤是否转移(OR=0.006,95%CI:0.001〜0.032,F=0.000).Charlson共病指数(OR=2.278,95%CI:1.772〜2.929,P=0.000)均是影响肺血栓栓塞症(PTE)形成的独立危险因素。结论患者年龄、肿瘤是否转移.Charlson共病指数是龛年肿瘤患者出现肺栓塞的独立危险因素。Objective To investigate clinical features and risk factors for pulmonary embolism in elderly patients with tumor-associated venous thromboembolism(VTE).Methods Patients aged≥65 years with malignant tumors combined with deep venous thromboembolism(DVT)in our hospital&om June 2014 to November 2018 were enrolled retrospectively.General information such as age,sex,date of hospitalization,primary tumor location,tumor metastasis,concomitant disease»thrombosis type and site were collected.The Charlson comorbidity index was calculated.According to the site of deep vein thrombosis,patients were divided into the DVT group and the pulmonary embolism(PTE)group.Risk factors for PE were analyzed statistically on the indicators in the two groups.Results Of the 318 patients,281(88.4%)were in the DVT group and 37(11.6%)were in the PE group.There were no statistically significant differences in age>sex,smoking history,length of hospital stay,primary tumor type or tumor metastasis between the two groups(P>0.05).The main comorbidities included hypertension,diabetes mellitus,atherosclerotic coronary disease,chronic obstructive pulmonary disease,heart failure,cerebrovascular disease,chronic kidney disease and chronic liver disease,and there was no statistically significant difference in the number of patients with the above diseases between the two groups(P>0.05).Charlson comorbidity index scores were higher in the PE group than in the DVT group(7.22±3.95 vs.5.69±2.89,P=0.028).Logistic regression analysis showed that age(OR=0.9,95%CI:0.846-0.985,P=0.001),tumor metastasis(OR=0.006,95%CI:0.001-0.032,P=0.000),and Charlson comorbidity index score(OR=2.278,95%CI:1.772-2.929,P=0.000)were all independent risk factors for PTE.Conclusions Age,tumor metastasis and Charlson comorbidity index score are independent risk factors for PE in elderly tumor patients.

关 键 词：肿瘤相关静脉血栓栓塞症 肺栓塞 共病 

分 类 号：R730.6[医药卫生—肿瘤]