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硼替佐米治疗多发性骨髓瘤患者发生感染的临床特征及危险因

          素分析
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          蒋文婷 ,周 洁 ,吕 波 ,施爱明 ,李炳宗 ,潘 杰 (1. 苏州大学附属第二医院药学部,江苏 苏州
                 1*
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                           1
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          215004;2.苏州大学附属第二医院血液科,江苏 苏州 215004)
          中图分类号  R969.3;R979.1      文献标志码  A      文章编号  1001-0408(2026)07-0942-07
          DOI  10.6039/j.issn.1001-0408.2026.07.20

          摘   要  目的  研究多发性骨髓瘤(MM)患者使用硼替佐米治疗后发生感染的临床特征及潜在危险因素。方法  回顾性收集2021
          年10月至2025年2月苏州大学附属第二医院血液科接受以硼替佐米为基础治疗方案的MM患者的临床资料,主要包括人口学特
          征、MM的疾病特征、用药方案、感染发生情况及相应处理措施、预防性用药等;对MM合并感染的潜在危险因素进行单因素及多
          因素Logistic回归分析。结果  在284例使用硼替佐米的MM患者中,132例患者至少发生了1次感染(占46.5%),感染类型以呼吸
          道感染和消化道感染为主。单因素分析结果显示,初诊年龄、病理分型、骨髓抑制分级是 MM 患者发生感染的影响因素(P<
          0.05)。进一步分析两种主要感染类型的影响因素,结果显示,性别、初诊年龄、病理分型、治疗方案、吸烟史是MM患者发生呼吸
          道感染的影响因素(P<0.05);BMI、病理分型、治疗方案、骨髓抑制分级是MM患者发生消化道感染的影响因素(P<0.05)。多因
          素Logistic回归分析结果显示,年龄≥70岁、治疗前存在Ⅳ级骨髓抑制为MM患者发生感染的危险因素,而IgG-λ型为MM患者发
          生感染的保护因素(P<0.05)。结论  以硼替佐米为基础治疗方案的MM患者感染发生率较高,并以呼吸道和消化道感染为主;初
          诊年龄、骨髓抑制分级、病理分型为MM患者发生感染的影响因素。
          关键词  多发性骨髓瘤;硼替佐米;感染;危险因素;真实世界研究

          Analysis  of  clinical  characteristics  and  risk  factors  for  infection  in  patients  with  multiple  myeloma  treated
          with bortezomib

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          JIANG Wenting ,ZHOU Jie ,LYU Bo ,SHI Aiming ,LI Bingzong ,PAN Jie(1. Dept. of Pharmacy, the Second
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                                                                     2
          Affiliated Hospital of Soochow University, Jiangsu Suzhou 215004, China;2. Dept. of Hematology, the Second
          Affiliated Hospital of Soochow University, Jiangsu Suzhou 215004, China)
          ABSTRACT    OBJECTIVE  To  study  the  clinical  characteristics  and  potential  risk  factors  for  infection  in  patients  with  multiple
          myeloma (MM)  following  treatment  with  bortezomib.  METHODS  Clinical  data  were  retrospectively  collected  from  MM  patients
          who  received  bortezomib-based  treatment  regimens  at  the  Department  of  Hematology,  the  Second Affiliated  Hospital  of  Soochow
          University,  from  October  2021  to  February  2025.  The  collected  data  primarily  included  demographic  characteristics,  disease
          characteristics  of  MM,  treatment  regimens,  occurrence  of  infections  and  corresponding  management  measures,  and  prophylactic
          medication  use.  Univariate  and  multivariate  Logistic  regression  analyses  were  conducted  to  identify  potential  risk  factors  for  MM
          complicated with infection. RESULTS Among the 284 MM patients treated with bortezomib, 132 patients (46.5%) experienced at
          least  one  infection.  The  predominant  types  of  infections  were  respiratory  tract  infections  and  gastrointestinal  infections.  Univariate
          analysis showed that age at initial diagnosis, pathological classification, and grade of myelosuppression were influencing factors for
                                                              infection  in  MM  patients  (P<0.05).  Further  analysis  of
              Δ 基金项目 中国药理学会药源性疾病学专业委员会2024年药物
          安全研究项目(No.ADR2024MS13);白求恩公益基金会“耀动神州-药              influencing  factors  for  the  two  main  types  of  infections
          学科研能力建设基金”项目(No.Z04JKM2023E040);江苏省老年医学             revealed  that  sex,  age  at  initial  diagnosis,  pathological
          学会重点课题(No.JGS2023ZDYX007);江苏省药学会-恒瑞医院药学
                                                              classification,  treatment  regimen,  and  smoking  history  were
          基金立项课题(No.H202330);苏州市药学会-恒瑞医药临床药学科研
          基金研究项目(No.Syhky202310)                              influencing  factors  for  respiratory  tract  infections  in  MM
             *第一作者 主管药师,硕士。研究方向:临床药学(血液、肿瘤方                   patients  (P<0.05) ;  BMI,  pathological  classification,
          向)。E-mail:1119124335@qq.com
                                                              treatment  regimen,  and  grade  of  myelosuppression  were
              # 通信作者 主任药师,硕士。研究方向:医院药学。E-mail:
          pankypan@163.com                                    influencing  factors  for  gastrointestinal  infections  in  MM


          · 942 ·    China Pharmacy  2026 Vol. 37  No. 7                               中国药房  2026年第37卷第7期
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