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目的探讨老年弥漫性大B细胞淋巴瘤(DLBCL)患者发生静脉血栓栓塞(VTE)的影响因素。方法选取我院2003年6月至2013年10月收治的142例老年DLBCL患者作为观察对象,分析性别、体质指数(BMI)、体能评分(ECOGPS)、肿瘤分期、乳酸脱氢酶水平(LDH)、高血压、糖尿病、血红蛋白水平、白细胞、血小板计数等因素与VTE发生的关系,并分析目前血栓治疗措施的疗效。结果单因素logistic回归分析结果显示:PS评分≥2(P=0.027)、国际淋巴瘤预后指数(IPI)积分=3~4分(P=0.051)、3~4个疗程化疗未达到完全缓解(non-CR,P=0.016)是影响老年DLBCL患者血栓形成的危险因素;多因素回归分析显示:PS评分≥2、3~4个疗程化疗non-CR是影响血栓形成的独立危险因素(P<0.05)。结论 PS评分≥2、3~4个疗程化疗non-CR是影响老年DLBCL患者血栓形成的独立危险因素。
Objective To investigate the influencing factors of venous thromboembolism (VTE) in elderly patients with diffuse large B cell lymphoma (DLBCL). Methods A total of 142 elderly patients with DLBCL admitted from June 2003 to October 2013 in our hospital were selected as the observation objects. Gender, body mass index (BMI), physical fitness score (ECOGPS), tumor stage, lactate dehydrogenase level (LDH) , Hypertension, diabetes mellitus, hemoglobin, white blood cells, platelet count and other factors with the occurrence of VTE, and analyze the efficacy of thrombosis treatment. Results The results of univariate logistic regression analysis showed that PS score ≥2 (P = 0.027), International Lymphoma Prognosis Index (IPI) score = 3-4 points (P = 0.051), 3 ~ 4 courses of chemotherapy did not reach complete remission non-CR, P = 0.016) were risk factors for thrombosis in elderly patients with DLBCL. Multivariate regression analysis showed that non-CR of 3 to 4 courses of chemotherapy was an independent risk factor for thrombosis (P < 0.05). Conclusion Non-CR chemotherapy with PS score ≥2,3 ~ 4 courses is an independent risk factor for thrombosis in elderly patients with DLBCL.