急性髓系白血病患儿化疗期间症状群发生情况及影响因素分析  

Analysis of symptom group occurrence and influencing factors in children with acute myeloid leukemia during chemotherapy

作　　者：蔡建萍[1] 周丹丽[2] 熊亚琴 鲍群谢 CAI Jian-ping;ZHOU Dan-li;XIONG Ya-qin;BAO Qun-xie(Department of Hematology,Children's Hospital,Zhejiang University School of Medicine,Hangzhou,Zhejiang 310000,China;不详)

机构地区：[1]浙江大学医学院附属儿童医院血液科,浙江杭州310000 [2]绍兴文理学院医学院护理实验室

出　　处：《中国妇幼保健》2024年第14期2611-2614,共4页Maternal and Child Health Care of China

基　　金：浙江省教育厅课题(Y202146530)。

摘　　要：目的分析急性髓系白血病(AML)患儿化疗期间症状群发生情况及其影响因素。方法回顾性分析2020年1月1日—2022年12月31日浙江大学医学院附属儿童医院收治的66例AML患儿的一般资料。采用记忆症状评估量表儿童版(MSAS10-18)评估患儿症状群发生情况,并根据患儿是否在化疗期间出现症状群,将66例AML患儿分为发生症状群组(47例)和未发生症状群组(19例)。比较两组患儿一般资料(性别、年龄、病程、住院时间、父母年龄、父母文化程度、家庭月收入及家庭关系等)。通过单因素和多因素logistic回归分析影响AML化疗期间发生症状群的因素,根据影响因素进行赋值用以建立风险评估模型,采用受试者工作特征(ROC)曲线评估模型诊断效能。结果66例患儿中,共有47例患儿在化疗期间出现症状群,其中神经心理不适症状群、头部相关症状群、胃肠道相关症状群、自我形象受损相关症状群、皮肤瘙痒-腹泻症状群、口腔相关症状群分别为3例、6例、11例、7例、14例及6例,依次占比6.38%、12.76%、23.40%、14.89%、29.78%及12.76%。发生症状群组年龄、病程、住院时间、父母年龄、父母文化程度、家庭月收入及家庭关系方面与未发生症状群组比较,差异均有统计学意义(均P<0.05)。多因素logistic回归模型分析结果显示,年龄(OR=5.783)、病程(OR=2.389)、父母年龄(OR=1.235)、父母文化程度(OR=32.460)、家庭月收入(OR=1.107)及家庭关系(OR=18.616)是患儿化疗期间发生症状群的独立影响因素(均P<0.05)。由ROC曲线分析,构建风险评估模型的AUC值最高,为0.968,且灵敏度、特异度分别为97.87%、89.36%。结论AML患儿在化疗期间症状群发生率较高,并以皮肤瘙痒-腹泻症状群、胃肠道相关症状群、自我形象受损相关症状群为主。AML患儿化疗期间发生症状群的独立影响因素包括患儿年龄、病程、父母年龄、父母文化程度、家庭�Objective To analyze the occurrence and influencing factors of symptom groups in children with acute myeloid leukemia(AML)during chemotherapy.Methods The general data of 66 children with AML admitted to the Children's Hospital of Zhejiang University School of Medicine from January 1,2020 to December 31,2022 were retrospectively analyzed.Symptom clusters were evaluated using the Memory Symptom Assessment Scale for Children(MSAS10-18).According to whether the children developed symptom clusters during chemotherapy,66 children with AML were divided into symptomatic group(47 cases)and asymptomatic group(19 cases).General data(gender,age,course of disease,length of stay,age of parents,educational level of parents,monthly family income and family relationship,etc.)were compared between the two groups.Univariate and multivariate logistic regression were used to analyze the factors affecting symptom clusters during chemotherapy for AML.The risk assessment model was established according to the values of the influencing factors.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of the model.ResultsAmong the 66 children,47 had symptoms during chemotherapy.There were 3 cases of neuropsychological discomfort,6 cases of head-related symptoms,gastrointestinal symptoms-related symptoms,self-image impairment symptoms-related symptoms,skin prurity-diarrhea symptoms-related symptoms and 6 cases of oral symptoms-related symptoms.The proportion was 6.38%,12.76%,23.40%,14.89%,29.78%and 12.76%.There were significant differences in age,duration of disease,length of hospital stay,age of parents,educational level of parents,monthly family income and family relationship between symptomatic group and non-symptomatic group(all P<0.05).Multivariate logistic regression model analysis results show that,age(OR=5.783),duration of illness(OR=2.389),age of parents(OR=1.235),educational level of parents(OR=32.460),monthly family income(OR=1.107)and family relationship(OR=18.616)were independent factors for the

关 键 词：急性髓系白血病 化疗 症状群 影响因素 

分 类 号：R725[医药卫生—儿科]