卵巢癌患者紫杉醇联合卡铂方案化疗所致血小板减少症的相关因素分析  

Analysis of related factors of chemotherapy-induced thrombocytopenia in ovarian cancer patients treated with paclitaxel and carboplatin regimen

作　　者：方宇航 杨舒涵 房立源 谢伊 王妍 王润兮 隋白鹭 张英[1] Fang Yuhang;Yang Shuhan;Fang Liyuan;Xie Yi;Wang Yan;Wang Runxi;Sui Bailu;Zhang Ying(Department of Oncology,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Graduate School,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院广安门医院肿瘤科,北京100053 [2]北京中医药大学研究生院,北京100029

出　　处：《实用药物与临床》2025年第2期103-106,共4页Practical Pharmacy and Clinical Remedies

基　　金：国家中医药传承创新团队项目(ZYYCXTD-C-202205);中国中医科学院科技创新工程重点协同攻关项目(C12022C002-03)。

摘　　要：目的回顾性分析卵巢癌患者紫杉醇+卡铂方案(TC方案)化疗所致血小板减少症(Chemotherapy-induced thrombocytopenia,CIT)的一般特征及CIT发生的相关因素。方法纳入2018年1月至2023年2月中国中医科学院广安门医院化疗的卵巢癌患者,收集患者年龄、体重指数(BMI)、化疗周期、病理类型、化疗前后检验指标等资料。采用Spearman相关性分析法分析化疗周期数与化疗期间最低血小板水平之间的相关性,采用多因素Logistic回归法分析采用TC方案治疗的卵巢癌患者CIT的影响因素。结果共纳入147例接受TC方案化疗的卵巢癌患者,CIT的发生率为23.81%。化疗周期数与化疗期间最低血小板水平呈较弱的负相关。多因素Logistic回归显示,排除其他因素影响后,化疗前较低的血小板水平是采用TC方案治疗的卵巢癌患者发生CIT的危险因素。利用化疗前血小板水平预测CIT的最佳阈值为174.5×10^(9)/L,灵敏度为69.6%,特异度为82.9%。结论排除混杂因素后,较低的化疗前血小板水平是采用TC方案治疗的卵巢癌患者发生CIT的危险因素。若患者应用TC方案化疗前的血小板水平低于174.5×10^(9)/L,则需密切关注患者化疗后血小板水平,以及时调整用药方案。Objective To retrospectively analyze the general characteristics of chemotherapy-induced thrombocytopenia(CIT)in ovarian cancer patients treated with paclitaxel and carboplatin(TC)regimen,and analyze the related factors of CIT.Methods Patients with ovarian cancer who received chemotherapy in Guang'anmen Hospital of China Academy of Chinese Medical Sciences from January 2018 to February 2023 were enrolled.Clinical data including age,body mass index(BMI),chemotherapy cycle,pathological type,and laboratory indicators before and after chemotherapy were collected.Spearman correlation analysis was used to analyze the correlation between the number of chemotherapy cycles and the minimum platelet level during chemotherapy.Multivariate Logistic regression was used to analyze the related factors of CIT in ovarian cancer patients treated with TC regimen.Results A total of 147 patients with ovarian cancer who were on TC chemotherapy regimen were enrolled.The incidence rate of CIT was 23.81%.There was a weak negative correlation between the number of chemotherapy cycles and ninimum platelet level during chemotherapy.Multivariate Logistic regression showed that platelet level before chemotherapy was a risk factor for CIT after excluding other factors.The optimal threshold of platelet level before chemotherapy to predict CIT was 174.5×10^(9)/L,with a sensitivity of 69.6%and a specificity of 82.9%.Conclusion After adjusting for confounding factors,lower pre-chemotherapy platelet level was a risk factor for CIT.If the platelet level of the patient is lower than 174.5×10^(9)/L before chemotherapy,it is necessary to pay close attention to the platelet level of the patient after chemotherapy and adjust the medication regimen in time.

关 键 词：肿癌化疗所致血小板减少症 卵巢癌 紫杉醇 卡铂 相关因素 

分 类 号：R969.3[医药卫生—药理学]