102例乳腺癌患者术后化疗相关性贫血情况及影响因素分析
发布时间：2018-10-16 18:47
【摘要】：目的通过对乳腺癌术后辅助化疗的患者进行研究,了解乳腺癌术后化疗相关性贫血发生情况及相关影响因素。方法本研究以回顾性分析的方式,收集2013年1月1日至2013年12月31日在我院行乳腺癌根治性手术,术后行至少4周期辅助化疗的患者的临床资料进行分析。结果1、本研究共入组乳腺癌术后辅助化疗的患者102例,均为女性患者,中位年龄47岁,年龄范围26岁-70岁。入组时患者血红蛋白均值为125.58±8.65g/L,化疗后最低血红蛋白均值为113.210±10.09g/L。乳腺癌患者术后辅助化疗相关性贫血的发生率为29.4%(30/102),均为轻度或中度贫血,无重度和极重度贫血。2、不同影响因素所致化疗相关性贫血的发生率不同。以所处的绝经状态分组,处于绝经后状态的患者化疗后贫血发生率较高(P㩳0.05);以年龄"g60岁和年龄㩳60岁分组、以民族(汉族、壮族)分组、以初诊时的红细胞平均体积(mean corpuscular volume MCV)参数分组、以初诊时平均红细胞血红蛋白含量(mean corpuscular hemoglobin MCH)参数分组、以初诊时平均红细胞血红蛋白浓度(mean corpuscular hemoglobin concentration MCHC)参数分组、以不同病理类型分组、以不同雌激素受体(estrogen receptor ER)分组、以不同孕激素受体(progesterone receptor PR)分组、以不同化疗方案分组的乳腺癌术后患者化疗后贫血发生率无统计学差异。不同周期后患者贫血率不同,完成1周期化疗后贫血率为7.8%,完成4周期化疗后的贫血发生率为20.0%。3、乳腺癌术后辅助化疗可以导致血红蛋白均值下降。初诊时MCV㩳80fl的患者化疗后血红蛋白均值较低(P㩳0.05);初诊时MCH㩳27pg的患者化疗后血红蛋白均值较低(P㩳0.05);初诊时MCHC㩳320g/L的患者化疗后血红蛋白均值较低(P㩳0.05);蒽环类序贯紫杉类方案化疗血红蛋白均值较低,与各方案组间比较有统计学差异(P㩳0.05)。根据年龄"g60岁和年龄㩳60岁分组、民族(汉族、壮族)分组、所处绝经状态分组、不同病理类型、不同ER表达分组、不同PR表达分组的乳腺癌术后患者化疗后血红蛋白均值无统计学差异(P㧐0.05);结论1、本组研究乳腺癌患者术后辅助化相关性贫血的发生率为29.4%(30/102),贫血的程度以轻中度为主;2、乳腺癌患者术后辅助化疗相关性贫血的发生率与患者所处的绝经状态有关;与患者年龄、民族、初诊时MCV、初诊时MCH、初诊时MCHC、病理类型、激素受体状态、化疗方案关系不确切。3、乳腺癌患者术后辅助化疗可致患者血红蛋白均值下降。初诊时MCV㩳80fl、初诊时MCH㩳27pg、初诊时MCHC㩳320g/L及采用蒽环类序贯紫杉类方案化疗的患者化疗后血红蛋白均值较低;不同年龄、不同民族、所处的绝经状态、不同病理类型、不同激素受体状态的患者化疗后血红蛋白均值无明显差异。
[Abstract]:Objective to investigate the incidence and related factors of chemotherapy-associated anemia in patients with breast cancer after adjuvant chemotherapy. Methods the clinical data of patients who underwent radical breast cancer surgery from January 1, 2013 to December 31, 2013 and received at least 4 cycles of adjuvant chemotherapy after operation were retrospectively analyzed. Results 1. 102 patients with adjuvant chemotherapy after breast cancer operation in this study were all female. The median age was 47 years and the age ranged from 26 to 70 years. The mean hemoglobin was 125.58 卤8.65 g / L and the lowest after chemotherapy was 113.210 卤10.09 g / L. The incidence of adjuvant chemotherapy-associated anemia was 29.4% (30 / 102) in patients with breast cancer. According to the menopausal status, the incidence of postmenopausal anemia was higher in the postmenopausal patients (P0. 05), and in the age group of "g60 years and age-60 years, the ethnic group (Han nationality, Zhuang nationality)," The mean volume of red blood cell (mean corpuscular volume MCV) was divided into three groups: the mean volume of red blood cell (mean corpuscular volume MCV) at first visit, the mean erythrocyte hemoglobin content (mean corpuscular hemoglobin MCH) at first visit, and the (mean corpuscular hemoglobin concentration MCHC) parameter of mean erythrocyte hemoglobin concentration (mean corpuscular hemoglobin concentration MCHC) at first visit. There was no significant difference in the incidence of postchemotherapy anemia in breast cancer patients with different pathological types, different estrogen receptor (estrogen receptor ER), different progesterone receptor (progesterone receptor PR) and different chemotherapy regimens. The anemia rate of patients after 1 cycle chemotherapy was 7.8, and that after 4 cycles of chemotherapy was 20.0.3.The mean hemoglobin level decreased after adjuvant chemotherapy for breast cancer. The mean value of hemoglobin after chemotherapy was lower in patients with MCV?80fl at first visit, lower in patients with MCH?27pg at first visit (P0. 05), lower in patients with MCHC?320g/L at first visit after chemotherapy (P0. 05), and in patients with anthracycline sequential yew chemotherapy (P0. 05). The mean value of erythroprotein was lower, There was statistical difference between the two groups (P0. 05). According to age "g 60 years old and age 60 years old, ethnic group (Han nationality, Zhuang nationality), menopausal state group, different pathological type, different ER expression group," There was no significant difference in the mean hemoglobin after chemotherapy in breast cancer patients with different PR expression groups (P0. 05). Conclusion 1. The incidence of adjuvant anemia in breast cancer patients after operation was 29. 4% (30 / 102), and the degree of anemia was mainly mild to moderate. The incidence of adjuvant chemotherapy-associated anemia in patients with breast cancer after operation was related to the menopausal status of the patients. Age, nationality, pathological type of MCHC, hormone receptor status and chemotherapeutic regimen were not exact. 3. The mean value of hemoglobin was decreased after adjuvant chemotherapy in patients with breast cancer. The mean value of hemoglobin in the patients with MCH?27pg, and anthracycline sequential yew chemotherapy was lower than that in the patients with MCH?27pg, at first visit and the patients treated with anthracycline sequential yew regimen, the mean value of hemoglobin was lower in different age, nationality, menopausal state and pathological type. There was no significant difference in mean hemoglobin after chemotherapy in patients with different hormone receptor states.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9;R556
[Abstract]:Objective to investigate the incidence and related factors of chemotherapy-associated anemia in patients with breast cancer after adjuvant chemotherapy. Methods the clinical data of patients who underwent radical breast cancer surgery from January 1, 2013 to December 31, 2013 and received at least 4 cycles of adjuvant chemotherapy after operation were retrospectively analyzed. Results 1. 102 patients with adjuvant chemotherapy after breast cancer operation in this study were all female. The median age was 47 years and the age ranged from 26 to 70 years. The mean hemoglobin was 125.58 卤8.65 g / L and the lowest after chemotherapy was 113.210 卤10.09 g / L. The incidence of adjuvant chemotherapy-associated anemia was 29.4% (30 / 102) in patients with breast cancer. According to the menopausal status, the incidence of postmenopausal anemia was higher in the postmenopausal patients (P0. 05), and in the age group of "g60 years and age-60 years, the ethnic group (Han nationality, Zhuang nationality)," The mean volume of red blood cell (mean corpuscular volume MCV) was divided into three groups: the mean volume of red blood cell (mean corpuscular volume MCV) at first visit, the mean erythrocyte hemoglobin content (mean corpuscular hemoglobin MCH) at first visit, and the (mean corpuscular hemoglobin concentration MCHC) parameter of mean erythrocyte hemoglobin concentration (mean corpuscular hemoglobin concentration MCHC) at first visit. There was no significant difference in the incidence of postchemotherapy anemia in breast cancer patients with different pathological types, different estrogen receptor (estrogen receptor ER), different progesterone receptor (progesterone receptor PR) and different chemotherapy regimens. The anemia rate of patients after 1 cycle chemotherapy was 7.8, and that after 4 cycles of chemotherapy was 20.0.3.The mean hemoglobin level decreased after adjuvant chemotherapy for breast cancer. The mean value of hemoglobin after chemotherapy was lower in patients with MCV?80fl at first visit, lower in patients with MCH?27pg at first visit (P0. 05), lower in patients with MCHC?320g/L at first visit after chemotherapy (P0. 05), and in patients with anthracycline sequential yew chemotherapy (P0. 05). The mean value of erythroprotein was lower, There was statistical difference between the two groups (P0. 05). According to age "g 60 years old and age 60 years old, ethnic group (Han nationality, Zhuang nationality), menopausal state group, different pathological type, different ER expression group," There was no significant difference in the mean hemoglobin after chemotherapy in breast cancer patients with different PR expression groups (P0. 05). Conclusion 1. The incidence of adjuvant anemia in breast cancer patients after operation was 29. 4% (30 / 102), and the degree of anemia was mainly mild to moderate. The incidence of adjuvant chemotherapy-associated anemia in patients with breast cancer after operation was related to the menopausal status of the patients. Age, nationality, pathological type of MCHC, hormone receptor status and chemotherapeutic regimen were not exact. 3. The mean value of hemoglobin was decreased after adjuvant chemotherapy in patients with breast cancer. The mean value of hemoglobin in the patients with MCH?27pg, and anthracycline sequential yew chemotherapy was lower than that in the patients with MCH?27pg, at first visit and the patients treated with anthracycline sequential yew regimen, the mean value of hemoglobin was lower in different age, nationality, menopausal state and pathological type. There was no significant difference in mean hemoglobin after chemotherapy in patients with different hormone receptor states.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9;R556
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相关期刊论文 前10条
1 范奎;代良敏;伍振峰;杨桂燕;杨明;;放化疗所致骨髓抑制的研究进展[J];中华中医药杂志;2017年01期
2 廖飞龙;杨仲t，
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