目的 探讨使用阿帕替尼治疗的恶性黑色素瘤患者中继发性高血压发生情况、相关危险因素及对预后的影响。方法回顾性分析2019年5月—2025年6月在南京大学医学院附属鼓楼医院综合肿瘤中心接受阿帕替尼联合治疗的恶性黑色素瘤患者共100例，通过调阅电子病历系统收集患者相关信息。应用SPSS 25.0进行单因素及多因素Logistic回归分析，确定影响继发性高血压的独立危险因素；采用Kaplan-Meier生存分析方法绘制生存曲线，Log-rank（Mantel-Cox）检验分析继发性高血压与患者无进展生存期（PFS）及总生存期（OS）的相关性，单因素及多因素Cox回归模型筛选患者生存期的独立影响因素。结果 100例患者中，53例出现继发性高血压。单因素及多因素Logistic回归分析发现500 mg用药剂量、女性、既往高血压病史、肝转移、身体质量指数（BMI） ≥24.8 kg·m^-2为影响患者继发性高血压的独立危险因素（P＜0.05）。继发性高血压能够改善患者的中位无进展生存期（mPFS）和中位总生存期（mOS）（P＜0.05），单因素及多因素Cox回归分析证明继发性高血压是改善患者PFS和OS的独立预后因素。结论 500 mg用药剂量、女性、既往高血压病史、肝转移、BMI≥24.8 kg·m^-2是影响患者继发性高血压的危险因素；继发性高血压的发生是患者治疗有效的标志之一。

Objective To investigate the incidence of secondary hypertension, related risk factors, and its impact on prognosis in malignant melanoma patients treated with apatinib. Methods A retrospective analysis was conducted on a total of 100 malignant melanoma patients who received apatinib monotherapy or combination therapy at the Comprehensive Oncology Center of Drum Tower Hospital Affiliated to Nanjing University Medical School from May 2019 to June 2025. Relevant patient information was collected by reviewing the electronic medical record system. SPSS 25.0 software was used to perform univariate analysis and multivariate logistic regression analysis to identify the independent risk factors for secondary hypertension. The Kaplan-Meier survival analysis method was adopted to plot survival curves, and the log-rank (Mantel-Cox) test was used to analyze the correlation between apatinib-related secondary hypertension and patients’ progression-free survival as well as overall survival. Additionally, univariate and multivariate Cox regression models were applied to screen out the independent influencing factors for patients’ survival time. Results Among 100 patients, 53 cases developed secondary hypertension. Univariate and multivariate logistic regression analyses revealed that a 500 mg dosage, female, a history of hypertension, liver metastasis, and BMI ≥ 24.8 kg·m^-2 were independent risk factors for secondary hypertension in patients (P < 0.05). Secondary hypertension was associated with improved median progression-free survival and median overall survival of the patients (P < 0.05). Additionally, univariate and multivariate Cox regression analyses confirmed that secondary hypertension served as an independent prognosis factor for improving patients’ PFS and OS. Conclusion 500 mg dosage, female, a history of hypertension, liver metastasis, and BMI ≥ 24.8 kg·m^-2 are risk factors for secondary hypertension. The development of secondary hypertension serves as one of the markers indicating effective treatment in these patients.

R285.64

国家自然科学基金面上项目（82073365，81872484）；南京大学医学院附属南京鼓楼医院临床研究专项资金（2024-LCYJ-DBZ-01）