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恶性肿瘤合并静脉血栓栓塞症患者的临床特点分析

Clinical Features of Cancer Patients with Venous Thromboembolism

  • 摘要:
    目的  分析恶性肿瘤合并静脉血栓栓塞症(VTE)患者的临床特点并探寻相关危险因素。
    方法  采用回顾性病例对照研究,调查恶性肿瘤合并VTE患者的临床及生存结局信息。采用卡方检验、Log rank检验和比例风险回归模型(Cox模型)等方法进行统计分析,采用GraphPad Prism8.0绘制生存曲线,分析VTE相关影响因素。
    结果  5年间共收治新发恶性肿瘤患者11 620例,其中合并VTE患者385例(3.31%)。恶性淋巴瘤患者合并VTE的比例最大,达到4.78%,其次是结直肠癌和乳腺癌,分别为4.40%和4.08%;联合治疗的患者比单一治疗方式发生VTE的比例高;分期越晚的患者合并VTE的比例越高;随访结果显示合并VTE患者中位生存时间为17.90月(95%CI: 10.21~25.59),1、3、5年生存率分别为51.89%、37.76%、18.88%;多因素分析结果显示年龄、性别、TNM分期是影响VTE患者预后的独立危险因素。
    结论  恶性肿瘤患者容易并发VTE,临床上应对高危患者密切观察、提早预防。

     

    Abstract:
    Objective  To investigate the clinical features of cancer patients with venous thromboembolism (VTE) and related risk factors.
    Methods  A retrospective case-control study was conducted to investigate the clinical and survival outcomes of cancer patients with VTE. Statistical analysis of VTE-related influencing factors was performed using chi-square test, Log rank test and proportional hazard regression model (Cox model). GraphPad Prism8.0 was used to draw the survival curve.
    Results  We collected 11 620 patients with new-onset cancer, including 385 patients with VTE. The incidence of VTE in cancer patients was 3.31%. The incidence of VTE in malignant lymphoma patients was the highest (4.78%), followed by colorectal cancer (4.40%) and breast cancer (4.08%). Patients treated with combination therapy had a higher rate of VTE. TNM staging was positively correlated with the proportion of VTE in cancer patients. The median survival time was 17.90 months (95%CI: 10.21-25.59), and the 1-, 3- and 5-year survival rates were 51.89%, 37.76% and 18.88%, respectively. Multivariate analysis results showed that age, gender and TNM staging were independent risk factors affecting the survival and prognosis of patients.
    Conclusion  Patients with malignant tumors are prone to VTE. High-risk patients should be closely observed to prevent VTE.

     

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