Objective: To understand and explore the risk factors of the death of lymphoma patients from cardiovascular disease. Methods: The medical records and death information of 1 173 patients with lymphoma were collected, cases that died from cardiovascular disease were screened. A binary logistic regression model was used to analyze the independent risk factors of patients with lymphoma died from cardiovascular disease. Results: Among 1 173 patients with lymphoma, 75 (6.4%) died of cardiovascular disease, including 27 cases of coronary heart disease, 25 cases of stroke, 7 cases of hypertension, 5 cases of sudden cardiac death, 4 cases of pulmonary embolism, 3 cases of heart failure, 4 cases of others. Among the patients who survived for more than 5 years, 16.1% (35/217) died of cardiovascular disease. Among those who survived for more than 10 years, 11.7% (7/60) died of cardiovascular disease. Multivariate Logistic regression analysis showed that the primary site of lymphoma (OR=0.521, P=0.039), stage (stage Ⅱ: OR=2.487, P=0.016; stage Ⅲ: OR=3.233, P=0.002) and cardiovascular toxicity in the course of diagnosis and treatment (OR=3.019, P=0.001) are independent influencing factors for the death of cardiovascular disease in patients with lymphoma. Patients whose primary sites of lymphoma were lymph nodes had lower risk of dying from cardiovascular disease, while the patients with stage Ⅱ to Ⅲ stage and cardiovascular toxicity during diagnosis and treatment had higher risk of dying from cardiovascular disease. Conclusions: Cardiovascular disease is an important factor affecting the survival of patients with lymphoma. With the extension of survival time, the risk of dying from cardiovascular disease increases significantly. The primary site, tumor stage, and cardiovascular toxicity that occur during the diagnosis and treatment may be the independent influencing factors for patients with lymphoma that die from cardiovascular disease.
目的: 了解淋巴瘤患者死于心血管病的情况,探讨淋巴瘤患者死于心血管病的危险因素。 方法: 收集1 173例已经发生死亡并且死亡原因已知淋巴瘤患者的病历资料和相关死亡信息,分析死于心血管病淋巴瘤患者的特点。采用二分类Logistic回归模型分析淋巴瘤患者死于心血管病的独立危险因素。 结果: 1 173例淋巴瘤患者中,死于心血管病75例(6.4%),其中冠心病27例,脑卒中25例,高血压7例,心源性猝死5例,肺栓塞4例,心力衰竭3例,其他心血管病4例。在生存时间超过5年的患者中,死于心血管病者占16.1%(35/217例)。在生存时间超过10年的患者中,死于心血管病者占11.7%(7/60例)。多因素Logistic回归分析显示,淋巴瘤的原发部位(OR=0.521,P=0.039)、分期(Ⅱ期:OR=2.487,P=0.016;Ⅲ期:OR=3.233,P=0.002)和诊疗过程中是否发生心血管毒性(OR=3.019,P=0.001)是淋巴瘤患者死于心血管疾病的独立影响因素,淋巴瘤原发部位为淋巴结的患者死于心血管病的风险低,淋巴瘤分期为Ⅱ~Ⅲ期、诊疗过程中发生心血管毒性的患者死于心血管病的风险高。 结论: 心血管病是影响淋巴瘤患者生存的重要因素,随着生存时间的延长,死于心血管的风险明显增加。淋巴瘤原发部位、分期和诊疗过程中是否出现心血管毒性可能是淋巴瘤患者死于心血管病的独立影响因素。.
Keywords: Cardiovascular Disease; Cause of death; Lymphoma; Onco-cardiology; Risk factors.