多发性骨髓瘤患者并发静脉血栓栓塞的危险因素分析  

Analysis of risk factors for venous thromboembolism in patients with multiple myeloma

作　　者：姚岚 孙舒君[1] 王子寅[2] Yao Lan;Sun Shujun;Wang Ziyin(Department of Hematology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Interventional Radiology Division,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院血液科,上海200025 [2]上海交通大学医学院附属瑞金医院介入科,上海200025

出　　处：《血管与腔内血管外科杂志》2024年第12期1519-1523,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨多发性骨髓瘤(MM)患者并发静脉血栓栓塞(VTE)的危险因素。方法收集2021年1月至2023年1月上海交通大学医学院附属瑞金医院收治的96例MM患者的临床资料,将化疗过程中与化疗首个疗程结束后7 d内发生VTE的32例患者作为VTE组,根据VTE组患者的性别按1:2的比例采用倾向评分匹配法选取64例未发生VTE的患者作为NVTE组。筛选出MM患者并发VTE的相关因素,将相关因素代入Logistic回归模型明确其危险因素。结果单因素分析结果显示,VTE组中年龄≥60岁、化疗前白细胞计数(WBC)≥13×10^(9)/L、化疗前D-二聚体(D-D)水平≥500μg/L、卧床时间≥7 d的患者比例均高于NVTE组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,年龄≥60岁、化疗前WBC≥13×10^(9)/L、化疗前D-D水平≥500μg/L、卧床时间≥7 d均为MM患者并发VTE的独立危险因素(P﹤0.05)。结论MM患者并发VTE的危险因素包括年龄、化疗前WBC、化疗前D-D水平、卧床时间。对于具备这些危险因素的MM患者,应于化疗过程中与化疗首个疗程结束后给予VTE筛查,一旦发生VTE,应及时给予药物治疗。Objective To investigate the risk factors for venous thromboembolism(VTE)in patients with multiple myeloma(MM).Method The clinical data of 96 patients with MM admitted to Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from January 2021 to January 2023 were collected.Thirty two patients with venous thromboembolism(VTE)during chemotherapy and within 7 d after the end of the first course of chemotherapy were included in the VTE group.According to the gender structure of patients in the VTE group,64 patients without VTE were selected as the NVTE group by the propensity score matching method according to the ratio of 1∶2.Screen out the relevant factors of MM concurrent VTE and incorporate them into the Logistic regression model to identify their risk factors.Result The results of univariate analysis showed that the proportion of patients aged≥60 years old,white blood cell(WBC)≥13×10^(9)/L before chemotherapy,D-dimer(D-D)level≥500μg/L before chemotherapy,and bed rest time≥7 d in the VTE group were higher than those in the NVTE group,and the differences were statistically significant(P<0.05).The results of multiple factor analysis showed that age≥60 years old,WBC≥13×10^(9)/L before chemotherapy,D-D level≥500μg/L before chemotherapy,and bed rest time≥7 d were all independent risk factors for VTE in MM patients(P<0.05).Conclusion The risk factors for concurrent VTE in MM patients include age,WBC count before chemotherapy,D-D level before chemotherapy,and bed rest time.For MM patients with the these risk factors VTE screening should be given during and after chemotherapy,and timely medication should be given in case of VTE formation.

关 键 词：多发性骨髓瘤 静脉血栓栓塞 危险因素 

分 类 号：R543[医药卫生—心血管疾病]