【摘要】：目的通過對(duì)乳腺癌術(shù)后輔助化療的患者進(jìn)行研究,了解乳腺癌術(shù)后化療相關(guān)性貧血發(fā)生情況及相關(guān)影響因素。方法本研究以回顧性分析的方式,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術(shù),術(shù)后行至少4周期輔助化療的患者的臨床資料進(jìn)行分析。結(jié)果1、本研究共入組乳腺癌術(shù)后輔助化療的患者102例,均為女性患者,中位年齡47歲,年齡范圍26歲-70歲。入組時(shí)患者血紅蛋白均值為125.58±8.65g/L,化療后最低血紅蛋白均值為113.210±10.09g/L。乳腺癌患者術(shù)后輔助化療相關(guān)性貧血的發(fā)生率為29.4%(30/102),均為輕度或中度貧血,無重度和極重度貧血。2、不同影響因素所致化療相關(guān)性貧血的發(fā)生率不同。以所處的絕經(jīng)狀態(tài)分組,處于絕經(jīng)后狀態(tài)的患者化療后貧血發(fā)生率較高(P㩳0.05);以年齡"g60歲和年齡㩳60歲分組、以民族(漢族、壯族)分組、以初診時(shí)的紅細(xì)胞平均體積(mean corpuscular volume MCV)參數(shù)分組、以初診時(shí)平均紅細(xì)胞血紅蛋白含量(mean corpuscular hemoglobin MCH)參數(shù)分組、以初診時(shí)平均紅細(xì)胞血紅蛋白濃度(mean corpuscular hemoglobin concentration MCHC)參數(shù)分組、以不同病理類型分組、以不同雌激素受體(estrogen receptor ER)分組、以不同孕激素受體(progesterone receptor PR)分組、以不同化療方案分組的乳腺癌術(shù)后患者化療后貧血發(fā)生率無統(tǒng)計(jì)學(xué)差異。不同周期后患者貧血率不同,完成1周期化療后貧血率為7.8%,完成4周期化療后的貧血發(fā)生率為20.0%。3、乳腺癌術(shù)后輔助化療可以導(dǎo)致血紅蛋白均值下降。初診時(shí)MCV㩳80fl的患者化療后血紅蛋白均值較低(P㩳0.05);初診時(shí)MCH㩳27pg的患者化療后血紅蛋白均值較低(P㩳0.05);初診時(shí)MCHC㩳320g/L的患者化療后血紅蛋白均值較低(P㩳0.05);蒽環(huán)類序貫紫杉類方案化療血紅蛋白均值較低,與各方案組間比較有統(tǒng)計(jì)學(xué)差異(P㩳0.05)。根據(jù)年齡"g60歲和年齡㩳60歲分組、民族(漢族、壯族)分組、所處絕經(jīng)狀態(tài)分組、不同病理類型、不同ER表達(dá)分組、不同PR表達(dá)分組的乳腺癌術(shù)后患者化療后血紅蛋白均值無統(tǒng)計(jì)學(xué)差異(P㧐0.05);結(jié)論1、本組研究乳腺癌患者術(shù)后輔助化相關(guān)性貧血的發(fā)生率為29.4%(30/102),貧血的程度以輕中度為主;2、乳腺癌患者術(shù)后輔助化療相關(guān)性貧血的發(fā)生率與患者所處的絕經(jīng)狀態(tài)有關(guān);與患者年齡、民族、初診時(shí)MCV、初診時(shí)MCH、初診時(shí)MCHC、病理類型、激素受體狀態(tài)、化療方案關(guān)系不確切。3、乳腺癌患者術(shù)后輔助化療可致患者血紅蛋白均值下降。初診時(shí)MCV㩳80fl、初診時(shí)MCH㩳27pg、初診時(shí)MCHC㩳320g/L及采用蒽環(huán)類序貫紫杉類方案化療的患者化療后血紅蛋白均值較低;不同年齡、不同民族、所處的絕經(jīng)狀態(tài)、不同病理類型、不同激素受體狀態(tài)的患者化療后血紅蛋白均值無明顯差異。
[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 鹵8.65 g / L and the lowest after chemotherapy was 113.210 鹵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.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.9;R556

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相關(guān)期刊論文 前10條

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本文編號(hào)：2275297