摘要
目的：分析肺癌合并静脉血栓栓塞症（ VTE）患者的临床特点及预后。方法对2003年1月至2013年4月北京医院住院的80例肺癌合并VTE患者的临床资料进行回顾性分析，记录年龄、性别、临床表现、病理类型、TNM分期、体力状态评分、化疗方案等临床信息，将肺血栓栓塞症（ PTE ）合并深静脉血栓形成（ DVT）者归入PTE组，分析肺癌合并VTE的发病情况和临床特点，了解预后。结果80例患者中男女各40例，年龄（65.8±11.3）岁；其中肺腺癌58例（72.5％），晚期肺癌71例（88.8％）；有病理组织分化结果者共37例（46.3％），其中中低分化占89.2％（33/37）；共32例（40.0％）患者接受化疗，其中含铂类化疗方案占71.9％（23/32）。80例患者中，PTE组和单独DVT组分别有35例（43.8％）和45例（56.2％）；在35例PTE中，14例（40.0％）为偶然发现。呼吸困难和肢体肿胀是合并VTE患者最常见症状。全部患者中仅20.0％（16/80）采取VTE预防措施；全部患者自诊断肺癌后3、6、9、12个月VTE的累积发生率分别为73.8％、77.5％、82.5％、85.0％。截至2013年4月，共有53例（66.3％）患者死亡，其中77.4％（41/53）死于肺癌，9.4％（5/53）死于PTE，13.2％（7/53）死于其他原因。在死亡患者中，诊断VTE后3、6、9、12个月的累积病死率分别为49.1％、67.9％、77.4％和79.2％。结论肺腺癌、晚期肺癌、病理组织分化程度低、含铂类化疗方案的肺癌患者，发生VTE的风险较高，且多发生于肺癌诊断后3～6个月；死亡事件多发生于VTE诊断后1年内。
Objective To explore the clinical characteristics and outcomes of lung cancer patients with venous thromboembolism （ VTE）.Methods The clinical data of 80 lung cancer patients with VTE hospitalized from January 2003 to April 2013 at our hospital were reviewed.The clinical factors of age , gender , clinical manifestations , pathological type , clinical stage , performance status and therapeutic regimen were recorded and analyzed.And the pulmonary thromboembolism （ PTE ） patients with deep venous thrombosis （ DVT） were enrolled into PTE group.The occurrences , clinical manifestations and prognosis of VTE were evaluated.Results A total of 80 patients were enrolled.There were 40 males and 40 females with a mean age of （65.8 ±11.3） years.Adenocarcimoma was identified in 58 （72.5%） patients and advanced lung cancer in 71 （88.8%） patients.Among 37 （46.3%） patients with histodifferentiation results , 89.2%（33/37） of them were moderately and/or poorly differentiated.In 32 （40.0%） patients on chemotherapy , 71.9% （ 23/32 ） of them received a platinum-based regimen.There were 35 （ 43.8%） pulmonary thromboembolism embolism （ PTE ） and 45 （ 56.2%） DVT patients.Among PTE patents , 14 （ 40.0%） were identified incidentally.Dyspnea and swollen of limb were the most common symptoms.Only 20.0%（16/80） patients received VTE prophylaxis.After a definite diagnosis of cancer , 73.8%, 77.5%, 82.5%and 85.0%of patients experienced an event within 3, 6, 9 and 12 months respectively.Up to April 2014, among 53 deceased patients , 77.4% （ 41/53 ） died from lung cancer , 9.3% （ 5/53 ） PTE while 13.2%（7/53） due to other causes.The cumulative mortality rates within 3, 6, 9 and 12 months after VTE eventwere 49.1%, 67.9%, 77.4% and 79.2% respectively.Conclusions Adenocarcimoma , advanced lung cancer, poor histodifferentiation and platinum-based chemotherapy regimen are the risk factors of VTE in lung cancer patients.Most events of VTE occur within 3-6 months after a diagnosis o
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第26期2045-2049,共5页
National Medical Journal of China
基金
国家科技支撑计划课题（2011BAI11B17）
首都卫生发展科研专项（首发2011-4011-05）
关键词
肺肿瘤
血栓栓塞
肺栓塞
静脉血栓形成
Lung neoplasms
Thromboembolism
Pulmonary embolism
Venous thrombosis
