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目的探讨不同部位、不同年龄癌症患者的贫血发生率;化疗前后贫血发生率及程度变化、不同化疗方案化疗后对贫血的影响。方法应用前瞻性随机对照研究方法对2007年7月至2009年2月期间在本院住院期间恶性肿瘤患者500例进行癌性贫血发生动态调查,化疗方案:小细胞肺癌:足叶乙甙+卡铂;非小细胞肺癌:顺铂或卡铂基础上加第三代化疗药物,如紫杉醇、吉西他滨、多西他赛等;乳腺癌:蒽环类±紫杉类;胃癌、结直肠癌、肝癌、淋巴瘤等均采用常规方案。结果①500例恶性肿瘤患者调查显示:不同部位、不同年龄、不同方案、不同性别、不同病理类型分组均有可比性。化疗前总贫血率30.8%,其中轻度贫血占88.3%。60岁以上(老年肿瘤患者)贫血发生率为36.6%;60岁以下肿瘤患者为22.0%,不同部位的肿瘤贫血发生率也不相同,其中以肺癌的发生率最高占42.1%。化疗后仍以肺癌最高,为92.4%。化疗后肿瘤患者贫血发生率78.8%,较化疗前贫血发生率30.8%(154/500)明显升高(χ2=232.543,P<0.01)。另外,化疗后贫血发生以中度贫血为主70.8%,含铂方案贫血发生率92.4%,非含铂方案贫血发生率73.2%,两组比较(χ2=22.657,P<0.01)。结论肿瘤患者贫血发生率在年龄上有差别,以老年人发生率较高,且以轻度贫血为主。化疗后贫血以中度为主,化疗加重贫血发生。不同癌症类型应用不同化疗方案引起贫血发生率各不相同,以铂类为基础的化疗方案导致贫血发生率更高。
Objective To investigate the incidence of anemia in patients with different parts of cancer at different ages, the incidence and extent of anemia before and after chemotherapy, and the effects of different chemotherapy regimens on anemia. Methods A prospective randomized controlled study was conducted to investigate the incidence of cancer-related anemia in 500 cancer patients during hospitalization from July 2007 to February 2009 in our hospital. The chemotherapy regimen: small cell lung cancer: etoposide Platinum; non-small cell lung cancer: cisplatin or carboplatin plus third-generation chemotherapy drugs, such as paclitaxel, gemcitabine, docetaxel; breast cancer: anthracyclines ± taxanes; stomach cancer, colorectal cancer, liver cancer , Lymphoma, etc. are using the conventional program. Results ①500 cases of malignant tumor patients survey showed: different parts, different ages, different programs, different genders, different pathological groups were comparable. The total anemia before chemotherapy was 30.8%, of which mild anemia was 88.3%. The incidence of anemia in patients over 60 years of age (elderly patients with cancer) was 36.6%, that of patients under 60 years of age was 22.0%, and that of different parts of patients was also different. The highest incidence of lung cancer was 42.1%. Lung cancer remains the highest after chemotherapy, 92.4%. The incidence of anemia in cancer patients after chemotherapy was 78.8%, which was significantly higher than that before chemotherapy (30.8%, 154/500) (χ2 = 232.543, P <0.01). In addition, the incidence of anemia was 70.8% in patients with chemotherapy, 92.4% in platinum-containing regimens, and 73.2% in non-platinum regimens (χ2 = 22.657, P <0.01). Conclusion The incidence of anemia in patients with cancer is different in age, with a higher incidence in the elderly, and mild anemia. Anemia after chemotherapy is moderate, chemotherapy aggravates anemia. The incidence of anemia varies among different cancer types using different chemotherapeutic regimens. Platinum-based chemotherapies lead to a higher incidence of anemia.