20 500例惡性腫瘤患者貧血情況分析

裴王偉 姜慧芬 范潤萍 陳勇毅 徐笑紅

[摘要]目的 分析20 500例惡性腫瘤患者的貧血情況。方法 回顧性分析2018年1～11月浙江省腫瘤醫院收治的20 500例惡性腫瘤患者臨床資料，計算不同腫瘤相關性貧血（CRA）的發生率;分析不同CRA的嚴重程度;分析CRA的年齡分布和性別分布。結果 20 500例CRA發生率為23.7%，CRA發生率最高的為婦科腫瘤，其次為消化和泌尿系統腫瘤，頭頸部腫瘤伴發貧血的發生率最低。CRA嚴重程度多數為1～2級[4424例（91.1%）]，3～4級CRA 434例（8.9%）。CRA的患者年齡多分布在50～<70歲，占60.07%，30～<50歲次之，占20.87%，<30歲最少，占1.26%。男性的CRA發生率高于女性，差異有統計學意義（P<0.05）。結論 CRA整體發生率較高，以1～2級貧血為主，男性CRA發生率高于女性。

[關鍵詞]惡性腫瘤;貧血;腫瘤相關性貧血;血紅蛋白

[中圖分類號] R73-31? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-4721（2020）2（c）-0180-03

Analysis of anemia in 20 500 patients with malignant tumors

PEI Wang-wei? ?JIANG Hui-fen? ?FAN Run-ping? ?CHEN Yong-yi? ?XU Xiao-hong▲

Department of Clinical Laboratory， Zhejiang Cancer Hospital， Hangzhou? ?310022， China

[Abstract] Objective To analyze the anemia of 20 500 patients with malignant tumor. Methods The clinical data of 20 500 patients with malignant tumors admitted to Zhejiang cancer hospital from January to November 2018 were analyzed retrospectively， the incidence of different tumor associated anemia （CRA） was calculated. The severity of different CRA were analyzed. The age distribution and gender distribution of CRA were analyzed. Results The incidence of CRA in 20，500 cases was 23.7%. The highest incidence of CRA was gynecological tumors， followed by digestive and urinary system tumors. The incidence of head and neck tumors with anemia was the lowest. The severity of CRA was mostly 4，424 （91.1%） in grades 1-2， and 434 （8.9%） of CRA in grades 3-4. The age of CRA patients were mostly distributed from 50 to <70 years， accounting for 60.07%， followed by 30 to <50 years， accounting for 20.87%， and the youngest were less than 30 years， accounting for 1.26%. The incidence of CRA was higher in men than in women， the difference was statistically significant （P<0.05）. Conclusion The overall incidence of CRA is high， with grade 1-2 anemia as the predominant factor， the incidence of CRA is higher in men than in women.

[Key words] Malignant tumor; Anemia; Cancer related anemia; Hemoglobin

腫瘤相關性貧血（cancer related anemia，CRA）是腫瘤患者本身或者治療過程中發生的貧血，是惡性腫瘤常見的并發癥之一。CRA的發生機制至今還未明確，可能與腫瘤本身、并發癥以及治療引起的骨髓抑制有關[1]。歐洲癌癥貧血調查（ECAS）對15 367例腫瘤患者進行了研究，發現64.5%的患者發生貧血[2]。CRA能顯著影響腫瘤的臨床治療效果和患者的生存期[3]，是影響腫瘤患者化療效果及生存率的獨立預后因素[4]。ECAS也提到，CRA與患者年齡、性別以及腫瘤類型等多種因素有關[5]。本研究對我院收治的20 500例惡性腫瘤患者資料進行回顧性分析，了解患者的貧血情況，現報道如下。

1資料與方法

1.1一般資料