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目的:探讨奈达铂致肺癌患者发生骨髓抑制的危险因素。方法:利用医院信息系统收集2015年6月至2018年8月在山东省千佛山医院接受以奈达铂为基础方案化疗的中晚期肺癌术后患者的病历资料进行回顾性分析。将患者按性别、年龄（<60岁或≥60岁）、谷胱甘肽巯基转移酶（GSTP）1A313G基因型（AA型或AG型）、病理分型（非小细胞肺癌或小细胞肺癌）、是否有吸烟史、是否合并肝损伤和是否合并肾损伤各分为2组，比较其骨髓抑制发生率和不同程度、不同表现骨髓抑制发生率，应用logistic回归分析法分析奈达铂致骨髓抑制的危险因素。结果:纳入分析的患者共46例，男性34例，女性12例。46例患者中30例在应用奈达铂后出现骨髓抑制，骨髓抑制总发生率为65.2%，其中Ⅰ~Ⅱ度者20例（43.5%），Ⅲ~Ⅳ度者10例（21.7%）。单因素分析结果显示，小细胞肺癌患者应用奈达铂后重度骨髓抑制发生率（3/5）高于非小细胞肺癌（17.1%）（n P<0.05）。男性肺癌患者应用奈达铂后白细胞减少总体发生率高于女性（58.8%比25.0%，n P=0.04）；吸烟患者白细胞减少和中性粒细胞减少的总体发生率高于既往无吸烟史者（68.0%比28.6%, n P=0.01; 64.0%比33.3%, n P=0.04）；小细胞肺癌患者血小板减少总体发生率高于非小细胞肺癌患者（4/5比9.8%，n P<0.01）。吸烟与不吸烟肺癌患者应用奈达铂后不同程度中性粒细胞减少的发生率差异有统计学意义（n P=0.03）；不同病理分型不同程度白细胞减少、中性粒细胞减少及血小板减少的发生率差异有统计学意义（均n P<0.01）。二元logistic回归法分析结果显示，相较于非小细胞肺癌，小细胞肺癌患者应用奈达铂后发生血小板减少的风险较高（n OR=25.00, 95n %CI：2.20~284.61, n P=0.01）；多元有序logistic回归分析结果显示，病理分型中小细胞肺癌是发生重度骨髓抑制、重度白细胞减少、重度中性粒细胞减少、重度血小板减少的危险因素（n OR=13.20, 95n %CI：n -4.67~0.49, n P=0.02; n OR=22.20, 95n %CI：n -5.37~0.83, n P=0.01; n OR=19.49, 95n %CI：n -5.11~0.82, n P=0.01; n OR=13.87, 95n %CI：n -4.89~0.38, n P=0.02）。n 结论:病理分型为小细胞肺癌是患者服用奈达铂后发生重度骨髓抑制的独立危险因素；有吸烟史的男性肺癌患者出现白细胞减少和中性粒细胞减少的概率更高。“,”Objective:To explore the risk factors of myelosuppression caused by nedaplatin in patients with lung cancer.Methods:The medical records of postoperative patients with advanced lung cancer and receiving nedaplatin-based chemotherapy in Shandong Provincial Qianfoshan Hospital from June 2015 to August 2018 were searched using hospital information system and analyzed retrospectively. According to sex, age (<60 years old, ≥ 60 years old), glutathione mercaptotransferase (GSTP) 1A313G genotype (AA or AG), pathological classification (non-small cell lung cancer, small cell lung cancer), having smoking history or not, being with or without liver injury and kidney injury, the patients were divided into 2 groups, respectively. The overall myelosuppression incidence and incidences of myelosuppression with different manifestations and different degrees were compared respectively between each 2 groups of patients with above-mentioned 7 different clinical features. The risk factors of nedaplatin-induced myelosuppression were analyzed using logistic regression.Results:A total of 46 patients were enrolled, including 34 males and 12 females. Among the 46 patients, 30 cases developed myelosuppression after administration of nedaplatin, and the overall incidence of myelosuppression was 65.2%, including 20 cases of grade Ⅰ-Ⅱ (43.5%) and 10 cases of grade Ⅲ-Ⅳ (21.7%). After administration of nedaplatin, the incidence of severe myelosuppression in patients with small cell lung cancer (3/5) was higher than that with non-small cell lung cancer (17.1%) (n P<0.05), showed by the univariate analysis; the overall incidence of leukopenia in males was higher than that in females (58.8% n vs. 25.0%); the overall incidence of leukopenia and neutropenia was higher in patients with smoking history than that in patients without previous smoking history (68.0% n vs. 28.6%, 0.01%, n P=0.01; 64.0% n vs. 33.3%, n P=0.04); the overall incidence of thrombocytopenia in patients with small cell lung cancer was higher than that with non-small cell lung cancer (4/5 n vs. 9.8%, n P<0.01); the differences in the incidences of different degrees of neutropenia in patients with and without smoking history were statistically significant (n P=0.03); the differences in the incidences of different degrees of leukopenia, neutropenia, and thrombocytopenia in patients with different pathological classification were statistically significant (n P<0.01 for all). The binary logistic regression analysis showed that the risk of thrombocytopenia in patients with small cell lung cancer was higher than that with non-small cell lung cancer (n OR=25.00, 95n %CI:2.20-284.61, n P=0.01). The orderial logistic regression analysis showed that a pathological classification of small cell lung cancer was a risk factor for severe myelosuppression, leukopenia, neutropenia, and thrombocytopenia (n OR=13.20, 95n %CI: -4.67-0.49, n P=0.02; n OR=22.20, 95n %CI: -5.37-0.83, n P=0.01; n OR=19.49, 95n %CI: -5.11-0.82, n P=0.01; n OR=13.87, 95n %CI: -4.89-0.38, n P=0.02).n Conclusions:A pathological classification of small cell lung cancer is an independent risk factor for severe myelosuppression in lung cancer patients after taking nedaplatin. Male patients with a history of smoking are more likely to have leukopenia/neutropenia.