目的：观察肿瘤抗血管生成药物治疗恶性肿瘤患者致高血压的发生情况及其处理，评估发生高血压的危险因素。方法收集2007年11月至2013年12月接受抗血管生成治疗的恶性肿瘤患者169例。抗血管生成治疗包括贝伐珠单抗联合化疗、帕唑帕尼、索拉非尼、舒尼替尼和阿昔替尼。观察高血压的发生情况，按照NCI-CTC AE 3�0标准对高血压进行分级，并采取相应的降压治疗措施。采用单因素分析和Logistic多元回归分析评估发生高血压的危险因素。结果169例晚期恶性肿瘤患者在接受抗血管生成治疗后，高血压的发生率为29�0％，其中Ⅲ级发生率为44�9％；经降压治疗后血压控制稳定，均未出现高血压危象。首次发生高血压的中位时间最早为4�5天；发生严重高血压的中位时间最早为11�0天。有既往高血压病史的患者和肾癌患者发生高血压的风险分别是无既往高血压病史患者和肾癌患者的4�494倍和2�541倍，其差异具有统计学意义（ P＜0�05）。结论抗血管生成治疗晚期恶性肿瘤患者致高血压的发生率较高，以中度为主，降压治疗效果较好。既往高血压史和肾癌是接受抗血管生成治疗后发生高血压的独立预测因子。%Objective To observe the incidence and management of hypertension induced by anti-angiogenic agents in patients with malignant carcinoma, and to evaluate the risk factor for hypertension. Methods 169 cancer patients treated with angio-genesis inhibition were collected from Nov. 2007 to Dec. 2013. All patients were diagnosed as malignant carcinoma by histopathology or cytology. Angiogenesis inhibition treatments included bevacizumab combined with chemotherapy, pazopanib, sorafenib, suntinib and axitinib. The incidence of hypertension was calculated and the severity of hypertension was classified according to NCI-CTC AE 3�0 cri-teria. The corresponding antihypertensive therapy was conducted. The risk factor for the occurrence of hypertension was evaluated by u-sing univariate analysis and Logistic regression analysis. Results The incidence of hypertension was 29�0% in 169 patients receiving anti-angiogenic agents, and among of which, incidence of gradeⅢwas 44�9%. The earlist medium time from the initiation of treatment to the occurrence of hypertension was 4�5 days and that of the grade Ⅲ hypertension was 11�0 days. The hypertension was controlled well after antihypertensive treatment. No serious hypertensive crisis was observed. The risk of hypertension medical history and kidney cancer had advantages at 4�494- and 2�541-fold as independent factors for predicting hypertension with statistical differences ( P<0�05) . Conclusion The incidence of hypertension induced by anti-angiogenic agents was high. The severity of hypertension was most-ly moderate, and the response to antihypertensive treatment is satisfying. Hypertension medical history and kidney cancer were inde-pendent predictor factors for the occurrence of hypertension after anti-angiogenic treatment.
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