摘要
目的:探讨肺癌患者并发静脉血栓栓塞(VTE)的危险因素及抗凝药使用情况。方法:通过某三甲医院信息系统(HIS系统),选取2006～2016年肺癌合并VTE患者为病例组,回顾性调查研究其抗凝药使用情况,并且以年龄、性别为匹配因素选取同期未并发VTE的肺癌患者作为对照组,采取配对病例对照研究方法探究肺癌患者并发VTE的危险因素。结果:在肺癌并发VTE患者中,抗凝药不合理使用率为45. 84%。低分子肝素为使用最多的抗凝药。危险因素研究中,单因素分析显示肺部疾病、肺癌分期、住院天数、白细胞计数(WBC)、红细胞计数(RBC)、D-二聚体、血栓风险评估量表(Caprini)评分、凝血酶原时间、活化部分凝血活酶时间和使用血管内皮抑制素是肺癌患者并发VTE的影响因素;多因素分析显示住院天数、RBC、D-二聚体是肺癌患者并发VTE的影响因素。结论:住院天数超过12 d、RBC降低、D-二聚体升高可能会增加肺癌患者并发VTE的风险,临床应予以警惕,及早采取预防措施,降低VTE的发生率。
Objective： To investigate the risk factors of venous thromboembolism （VTE） and the use of anticoagu- lant in lung cancer patients. Methods：Through the hospital HIS system, lung cancer who combined with VTE and hospital- ization from 2006 to 2016 were selected as the case group, take a retrospective investigation of the usage of anticoagulant, and take a matched case control study to explore the risk factors of VTE in lung cancer patients, in this study lung cancer patients without VTE in the same period and match with age and sex were selected as control group. Results：In lung cancer patients who complicated with VTE, the irrational use rate of anticoagulant drugs was 45.84%. Low Molecular Heparin was the most used anticoagulant drug. In univariate analysis, lung cancer patients with concurrent VTE were associated with pulmonary disease, lung cancer staging, length of hospital stay, WBC, RBC, D-dimer, Caprini score, PT, APTT and Vascular endothelial inhibitor. In multivariate analysis, length of hospital stay, RBC and D-dimer were the risk factors. Conclusion：Length of hospital stay more than 12 days, decreasing level of RBC, increasing level of D-dimer could proba- bly increase the risk of VTE in lung cancer patients, therefore proper attention should be paid to these factors in clinical practice and preventive measures should be taken to reduce the incidence of VTE.
作者
邱征威
张馨引
李粤琴
叶倩倩
李湘平
Qiu Zhengwei;Zhang Xinyin;Li Yueqin;Ye Qianqian;Li Xiangping(Department of Pharmacy,Xiangya Hospital,Central South University,Changsha 410008,China;College of Pharmacy,Hubei University of Science and Technology)
出处
《药物流行病学杂志》
CAS
2018年第10期685-690,共6页
Chinese Journal of Pharmacoepidemiology
关键词
静脉血栓
肺癌
危险因素
配对病例对照研究
Venous thromboembolism
Lung cancer
Risk factors
Matched case-control study
