化疗相关恶心呕吐危险因素的性别差异  

Gender difference in risk factors for chemotherapy-related nausea and vomiting

作　　者：孙博[1] 刘勋 王会品[1] 李淑芳[1] 张二锋 马换青 潘丽丽[1] 刘丹娜[1] SUN Bo;LIU Xun;WANG Hui-pin;LI Shu-fang;ZHANG Er-feng;MA Huan-qing;PAN Li-li;LIU Dan-na(Department of Pharmacy,The Third People’s Hospital of Zhengzhou,Zhengzhou 450099;Department of Pharmacy,Zhengzhou Second Hospital,Zhengzhou 450006)

机构地区：[1]郑州市第三人民医院药学部,郑州450099 [2]郑州市第二人民医院药学部,郑州450006

出　　处：《中南药学》2022年第5期1176-1182,共7页Central South Pharmacy

基　　金：河南省医学科技攻关项目(No.LHGJ20200721)。

摘　　要：目的探索不同性别患者化疗相关恶心呕吐(CINV)危险因素的差异,为临床用药提供参考。方法采用回顾性病例对照研究,以某院871例化疗患者为对象,其中男性448例,女性423例,分别统计人口学数据,病史资料,检查情况,治疗信息等资料共32项。以CINV为终点,采用单因素分析、向后似然比逐步回归法进行变量筛选。将筛选后的变量纳入多因素Logistic回归。使用多层感知神经网络预测各危险因素的重要性。结果结果显示男性独有的独立危险因素3项,分别为体表面积、阿片类止痛药应用、首次化疗;女性独有的独立危险因素1项,为化疗前紧张焦虑情绪;男女共有的独立危险因素6项,分别为胃肠道疾病史、手术史、电解质紊乱、化疗前24 h恶心呕吐、化疗呕吐史,化疗方案致吐风险等级。男性患者的独立危险因素中,化疗前24 h恶心呕吐(100.0%),体表面积(96.5%),化疗方案致吐风险等级(96.3%)的相对重要性较高。女性患者的独立危险因素中,化疗方案致吐风险等级(100.0%),化疗前24 h恶心呕吐(78.3%),紧张焦虑情绪(58.8%)的相对重要性较高。结论CINV的发生与多种因素相关,不同性别的患者,CINV的危险因素有所不同,各危险因素的重要性亦有不同。体表面积更大、使用阿片类药物、首次化疗的男性更容易发生CINV;存在紧张焦虑情绪的女性更容易发生CINV。医师在化疗前应充分考虑患者的性别差异,有针对性地对CINV进行预防。Objective To determine the difference in the risk factors for chemotherapy-related nausea and vomiting(CINV)in patients of different genders,and to provide references for clinical safe medication use.Methods A retrospective case-control study was conducted involving 871 chemotherapy patients in a hospital(448 males and 423 females).The demographic data,medical history,examination results,treatment information and other data were recorded with 32 items in total.With CINV as the endpoint,single-factor analysis,and backward likelihood ratio stepwise regression were used to screen the variables.The selected variables were incorporated into the multivariate Logistic regression.The regression model was constructed,and the multi-layer perceptual neural network was used to predict the importance of each risk factor.Results Three independent risk factors unique to males,included the body surface area,use of opioid analgesics,and first chemotherapy.The only independent risk factor unique to women was anxiety before the chemotherapy.Six independent risk factors for both men and women included the history of gastrointestinal diseases,history of surgery,electrolyte disorder,nausea and vomiting 24 h before the chemotherapy,history of vomiting during the chemotherapy,and the risk level of vomiting caused by chemotherapy.Among the independent risk factors for male patients,nausea and vomiting 24 h before chemotherapy(100.0%),body surface area(96.5%),risk level of chemotherapy-induced vomiting were relatively important(96.3%).Among the independent risk factors for female patients,chemotherapy regimen-induced nemesis(100.0%),nausea and vomiting(78.3%)24 h before chemotherapy,and anxiety(58.8%)were relatively important.Conclusion The occurrence of CINV involves many factors.Patients of different genders have different risk factors for CINV,and the importance of each risk factor also vary.Men with larger body surface areas,opioids,and first chemotherapy are more likely to develop CINV;women with anxiety and tension are more likely t

关 键 词：化疗相关恶心呕吐 危险因素 性别差异 

分 类 号：R453[医药卫生—治疗学]