胃癌术后辅助化疗前患者贫血发生情况的调查

目的探讨胃癌术后辅助化疗前患者贫血发生的危险因素、临床特点和发病规律。方法回顾性分析近1年住院接受辅助化疗胃癌患者的临床资料。统计贫血的发生率及贫血的发病程度，从单因素、多因素两个层面针对年龄、性别、临床分期、手术方式、病理组织类型、血清白蛋白水平等诸方面对贫血发生发展的影响进行分析。结果232例胃癌术后辅助化疗前患者，贫血发生率53．5％。单因素，分析：年龄≥60岁的贫血构成比显著高于年龄〈60岁的患者（P〈0．05）；女性患者贫血构成比显著高于男性患者（P〈0．05）；Ⅲ、Ⅳ期患者的贫血构成比明显高于Ⅰ、Ⅱ期患者（P〈0．05）；不同手术方式贫血发生率差异存在统计学意义（P〈0．05）；血清白蛋白水平低于35g／L的患者贫血发生率明显高于不低于35g／L的患者（P〈0．05）。Logistic多因素逐步回归分析表明年龄比数比（OR）26．422，95％可信区间（CI）5．716～122．129]、血清白蛋白（OR4．987，95％CI1．840～13．514）、病理分期（OR4．590，95％CI1．488。14．163）、手术方式（OR9．440，95％CI2．313～38．535）是胃癌术后辅助化疗前患者合并贫血的独立危险因素。结论胃癌术后辅助化疗前贫血的发生与年龄、血清白蛋白、手术方式、分期等因素有相关性。高龄、营养不良、全胃切除、中晚期患者更易发生贫血。

Investigation on occurence of anemia in gastric cancer patients after surgery before received adjuvant chemotherapy

Objective To explore the risk factors, clinical features and incidence of anemia in gastric cancer patients before received adjuvant chemotherapy. Methods Analyze the clinical records of gastric cancer patients before received adjuvant chemotherapy, hospitalized in the Cancer Department of ZhnngDa hospital af- filiated to Southeast University from February to December of 2008. Comparison between groups of anemia and non anemia were made by univariate analysis and multivariate analysis of logistic regression according to the age, sex, surgical mode, histopathological category, pathological stage, serum albumin. Results Pretreatment anemia was~ present in 53.5% of the patients. Anemia was significantly more within age group over 60 years as compared to less than 60 years ones （P 〈 0.05 ）. Anemia was significantly more within females as compared to males（ P 〈 0.02）. Anemia was significantly more with patients with HI and IV stage as compared to patients with I and II stages （ P 〈 0.05 ）. The statistically significant differences were found among different surgical methocls（P 〈0.05）. Anemia was significantly more among patients whose serum albumin concentration is less than 35 g/L compared to those whose serum albumin concentration is more than 35 g/L（ P 〈 0.05 ）. Four risk factors finally entered into the model of Logistic regression： age （OR 26. 422,95% CI 5. 716-122. 129 ） ,Serum albumin （ OR 4.987,95 % CI 1. 840 -122.129 ）, Pathological stage （ OR 4. 590,95 % CI 1. 488-14.163 ）, surgical mode （ OR 9. 440,95% CI 2.313-38. 535 ）. Conclusions pretreatment anemia was found to have close correlaion with age,Pathological stage,surgical mode and Serum albumin eoneentration in gastric cancer patients received adjuvant chemotherapy.