肺癌化疗患者血常规变化与骨髓抑制发生的危险度  

Study on the correlation of blood routine changes with the risk of bone marrow suppression in patients with lung cancer after chemotherapy

作　　者：王明伟[1] 万东东 李曙光 王倩兰 李伟[1] 党亚正 WANG Mingwei;WAN Dongdong;LI Shuguang;WANG Qianlan;LI Wei;DANG Yazheng(Department of Radiotherapy, The Third People's Hospital Affiliated Nantong University, Nantong 226000, Jiangsu, China;Department of Oncology, Jiangsu Haimen People's Hospital, Haimen 226126, Jiangsu, China;Cancer Center, 986 Hospital Affiliated The Fourth Military Medical University, Xi’an 710054, China)

机构地区：[1]南通大学附属第三医院放疗科,江苏南通226000 [2]海门市人民医院肿瘤科,江苏南通226126 [3]中国人民解放军空军986医院综合内科,陕西西安710054

出　　处：《西部医学》2020年第11期1634-1637,共4页Medical Journal of West China

基　　金：陕西省自然科学基金(CWS105B07);南通市市级科技项目(JCZ18113)。

摘　　要：目的探讨肺癌患者化疗后血常规变化与骨髓抑制发生的危险度。方法纳入2009年9月~2019年9月南通大学附属第三医院、海门市人民医院、中国人民解放军空军986医院3个医院的140例肺癌患者,其中68例在化疗后出现重度骨髓抑制(重度骨髓抑制组)及72例化疗后出现轻度骨髓抑制(轻度骨髓抑制组)。分析两组单核细胞、淋巴细胞与中性粒细胞等血常规变化的相关性及其与骨髓抑制发生的危险度。结果两组肺癌患者在年龄、性别、治疗前白细胞水平、血红蛋白水平、白蛋白水平及进食减少等比较差异均无统计学意义(P>0.05),在早期出现单核细胞明显下降比较差异具有统计学意义(P<0.05),且早期出现单核细胞计数明显下降是重度骨髓抑制的独立危险因素(OR=0.532,95%CI=1.157-3.809,χ^2=0.876,P=0.034)。化疗后血液中单核细胞计数与中性粒细胞下降计数成正相关(r=0.673,P<0.05)。结论化疗后早期单核细胞计数大幅度下降的肺癌患者发生重度骨髓抑制的危险度高,临床需要提早干预。Objective To investigate the relationship of blood routine changes with the risk of bone marrow suppression in patients with lung cancer after chemotherapy.Methods Between September 2009 and September 2019,140 lung cancer patients after chemotherapy in three hospitals were retrospectively analyzed.68 cases appeared severe bone marrow suppression and 72 cases appeared mild bone marrow suppression.The correlation of patients’routine blood changes such as mononuclear cells,lymphocytes and neutrophils were analyzed.The risk of bone marrow suppression was evaluated.Results There was no significant differences in age,sex,white blood cell level,hemoglobin level,albumin level,and dietary intake reduction between patients with severe bone marrow suppression and those with mild bone marrow suppression(P>0.05).The significant decrease of mononuclear cell count in early stage was an independent risk factor for severe bone marrow suppression(OR=0.532,95%CI=1.157-3.809,χ^2=0.876,P=0.034).After chemotherapy,the number of monocytes in blood was positively correlated with the number of neutrophils decreased,which the Pearson coefficient was 0.673(P<0.05).Conclusion Lung cancer patients with early mononuclear cell count decreased after chemotherapy have a high risk of severe bone marrow suppression,which they needed clinically early intervention.

关 键 词：肺癌 单核细胞计数 骨髓抑制 危险度 化疗 

分 类 号：R734.2[医药卫生—肿瘤]