真实世界下贝伐珠单抗致严重高血压的危险因素分析  

Risk factors for severe hypertension induced by bevacizumab in the real world

作　　者：李琳 李卓然 张文静[3] 郝志英[3] LI Lin;LI Zhuoran;ZHANG Wenjing;HAO Zhiying(Department of Pharmacy,Shanxi Medical University,Taiyuan,030001,Shanxi,China;Fenyang College of Shanxi Medi-cal University,Fenyang,032200,Shanxi,China;Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital of Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan,030013,Shanxi,China)

机构地区：[1]山西医科大学药学院,山西太原030001 [2]山西医科大学汾阳学院,山西汾阳032200 [3]山西省肿瘤医院/中国医学科学院肿瘤医院山西医院/山西医科大学附属肿瘤医院,山西太原030013

出　　处：《肿瘤药学》2023年第2期194-199,共6页Anti-Tumor Pharmacy

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.2020-10-93)。

摘　　要：目的探讨真实世界下贝伐珠单抗致严重高血压的危险因素。方法收集2020年1月—2022年1月山西省某三级甲等肿瘤专科医院接受贝伐珠单抗治疗患者的临床资料,依据用药后是否发生严重高血压将患者分为严重高血压组和非严重高血压组。采用单因素分析和Logistic回归分析,确定发生严重高血压的独立危险因素。结果共纳入300例患者,其中61例(20.3%)出现严重高血压;单因素分析结果显示,吸烟史、高血压史、贝伐珠单抗累积剂量均与接受贝伐珠单抗治疗患者发生严重高血压有明显相关性(P<0.05);多因素Logistic回归分析表明,高血压史(OR=2.512,95%CI:1.321~4.776,P=0.005)和贝伐珠单抗累积剂量(P=0.033)是导致患者严重高血压发生的独立危险因素,且累积剂量≤2000 mg发生严重高血压的风险较大(OR=3.704,95%CI:1.081~12.692,P=0.037)。结论贝伐珠单抗累积剂量、高血压史是接受贝伐珠单抗治疗患者发生严重高血压的高危因素,临床需加强重点监护,提倡健康的生活方式,必要时采取积极的干预措施,以保障患者治疗的顺利进行。Objective To investigate the risk factors of severe hypertension in patients treated with bevacizumab.Methods The clinical data were collected of patients who were treated with bevacizumab in a tumor hospital in Shanxi prov-ince between January 2020 and January 2022.Patients were divided into severe hypertension group and non-severe hyper-tension group according to whether severe hypertension occurred after medication.Univariate analysis and Logistic regres-sion analysis were used to determine the independent risk factors of severe hypertension.Results A total of 300 patients were enrolled,and 61 patients(20.3%)of them had severe hypertension.Univariate analysis showed that smoking history,hypertension history and cumulative dose of bevacizumab had a significant correlation with severe hypertension in patients receiving bevacizumab(P<0.05).Multivariate Logistic regression showed that hypertension history(OR=2.512,95%CI:21.321~4.776,P=0.005)and cumulative dose of bevacizumab(P=0.033)were independent risk factors for severe hyperten-sion,and a cumulative dose less than 2000 mg(OR=3.704,95%CI:1.081~12.692,P=0.037)was associated with a greater risk of severe hypertension.Conclusion Hypertension history and cumulative dose of bevacizumab are high-risk factors for severe hypertension in patients who received bevacizumab treatment.Clinical monitoring should be strengthened,healthy lifestyle should be advocated,and active intervention measures should be taken when necessary,so as to ensure the prog-ress of treatment.

关 键 词：真实世界 贝伐珠单抗 严重高血压 危险因素 

分 类 号：R979.1[医药卫生—药品]