摘要
目的探讨肺癌合并肺栓塞(pulmonary thromboembolism,PTE)的危险因素,为有效防治肺癌患者并发PTE提供参考依据。方法采用1∶3配比设计的病例对照研究方法,对郑州大学第五附属医院2009-02-03-2014-05-01收治的35例肺癌合并PTE患者和经年龄与性别匹配的105例肺癌患者进行条件Logistic回归分析。结果单因素条件Logistic回归分析显示,合并慢性阻塞性肺病、超重、肺腺癌、肺癌Ⅲ~Ⅳ期、化疗、中心静脉置管、白细胞增高、血红蛋白增高和D-二聚体增高等因素为肺癌合并PTE的危险因素,P<0.05。多因素条件Logistic回归分析显示,肺腺癌(OR=2.17,95%CI为1.34~3.51)、肺癌Ⅲ~Ⅳ期(OR=2.87,95%CI为1.69~4.95)、化疗(OR=2.84,95%CI为1.54~5.23)、白细胞增高(>11×109 L-1,OR=3.09,95%CI为1.85~5.17)和D-二聚体增高(>500ng/L,OR=2.66,95%CI为1.50~4.71)等因素为肺癌合并肺栓塞的危险因素。合并PTE肺癌患者生存时间显著低于不合并PTE肺癌患者,χ2=16.998,P<0.001。结论肺腺癌、晚期肺癌、化疗、高白细胞、高D-二聚体肺癌患者并发PTE的风险增加,应作为PTE重点防治对象。
OBJECTIVE To investigate the risk factors of lung cancer combined with pulmonary thromboembolism （PTE） in order to provide the basis for the effective prevention and treatment of lung cancer patients with PTE. METH- ODS A 1 ~ 3 pair-matched, case-control study was conducted in 35 cases of lung cancer combined with PTE and 105 age- sex-matched controls were treated in our hospital from February 3, 2009 to May 1, 2014 and analyzed by conditional lo- gistic regression analysis. RESULTS Univariate conditional logistic regression showed that with chronic obstructive pul- monary disease, overweight, adenocarcinoma, lung cancer stage Ⅲ~Ⅳ, chemotherapy, central venous catheter, high white blood cells, high hemoglobin and high D-dimer were risk factors for lung cancer with PTE （P^0.05）. Multivariate conditional logistic regression showed that adenocarcinoma （OR= 2.17, 95 ~ CI ： 1.34-- 3.51）, lung cancer stage HI - IV （OR=2.87, 95%CI： 1.69--4.95）, chemotherapy （OR=2.84, 95%0CI：1.54--6.23）, high white blood cells （〉11×10^9L^-1, OR=3.09, 95%CI： 1.85--5.17） and high D-dimer （〉500 ng/L, OR=2.66, 95%CI： 1.50--4.71） were risk factors for lung cancer combined with PTE. The survival time in patients with PTE was remarkably lower than that in pa- tients without PTE （^（z = 16. 998, P〈0. 001）. CONCLUSION The lung cancer patients with adenocarcinoma, or late stage disease, chemotherapy, high white blood cell and high D-dimer are more likely to be complicated with PTE, which should be the focus of prevention and treatment.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2015年第11期863-866,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
肺栓塞
肺肿瘤
危险因素
病例对照研究
pulmonary thromboembolism lung neoplasms risk factors case-control study
