目的 探索初诊恶性实体肿瘤患者发生贫血的相关因素。方法 回顾清华大学第一附属医院血液肿瘤科2014-05至2019-05收治的401例初诊恶性实体肿瘤患者,分析性别、年龄、肿瘤类型、肿瘤分期、KPS评分、白蛋白、胆固醇、C反应蛋白(CRP)及铁蛋白对贫血发生的影响。结果 401例中,男性224例(55.9%),女性177例(44.1%),中位年龄 71岁(28~95岁),初诊有贫血患者251例(62.6%)。单因素分析显示年龄>60岁、泌尿系统肿瘤、肿瘤分期Ⅳ期、KPS评分<70分、白蛋白<40 g/L、胆固醇水平正常及CRP、铁蛋白水平升高者,贫血的发生率升高(P<0.05)。多因素Logistic回归分析显示,低白蛋白血症(OR=6.981,95%CI 3.914~12.450)及KPS 评分<70分(OR=1.835,95% CI 1.028~3.274)是初诊恶性实体肿瘤患者发生贫血的独立危险因素。KPS评分、血清白蛋白及胆固醇水平与血红蛋白浓度呈正相关,而年龄、CRP及铁蛋白水平与血红蛋白呈负相关。结论 初诊恶性实体肿瘤患者贫血发生率高,受多种因素的影响,其中低白蛋白血症及KPS评分<70分是初诊恶性实体肿瘤贫血发生的独立危险因素。
Abstract
Objective To explore the factors related to anemia in patients with newly diagnosed malignant solid tumors.Methods The clinical data on 401 newly diagnosed patients with malignant solid tumors admitted to our department between May 2014 and May 2019 was reviewed. The effect of gender, age, types of tumors, tumor stage,KPS scores, albumin, cholesterol, C-reactive protein (CRP) and ferritin on the occurrence of anemia was analyzed.Results Among the 401 patients, 224 were males (55.9%), 177 were females (44.1%), the median age was 71 years (28-95 years), and 251 (62.6%) were diagnosed with anemia. Univariate analysis showed that age over 60, urinary system tumors, tumor stage Ⅳ, a KPS score <70 points, albumin <40 g/L, normal cholesterol levels, and elevated CRP and ferritin levels could increase the chance of anemia (P<0.05). Multivariate logistic regression analysis showed that hypoalbuminemia(OR=6.981,95%CI 3.914-12.450) and KPS score <70(OR=1.835,95%CI 1.028-3.274) were independent risk factors for anemia in patients with newly diagnosed malignant solid tumors. KPS scores and serum levels of albumin and cholesterol were positively correlated with hemoglobin concentrations, while age, CRP and ferritin levels were negatively correlated.Conclusions The incidence of anemia in newly diagnosed patients with malignant solid tumors is high, which has different causes. Hypoalbuminemia and a KPS score <70 are independent risk factors for anemia in patients with newly diagnosed malignant solid tumors.
关键词
初诊 /
恶性实体肿瘤 /
贫血 /
影响因素
Key words
newly diagnosed /
malignant solid tumor /
anemia /
influencing factors
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基金
清华大学第一附属医院2020年度领航基金(LH-01)
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