摘要
目的分析肺癌合并急性肺血栓栓塞症(APE)患者的临床特点、预后和危险因素。方法连续回顾性选择自2010年1月至2017年12月在北京世纪坛医院诊治的58例肺癌合并APE患者为APE组,按照1:2比例选择年龄、性别类似、同期入院的无APE的116例肺癌患者为非APE组,比较两组一般资料,随访患者预后情况,随访截止时间为2018年12月31日,Kaplan-Meier生存分析和log-rank检验比较两组的中位生存时间,单因素和多因素logistic回归分析影响APE的危险因素。结果174例患者中,平均年龄(51.9±18.3)岁。两组间的年龄、男性比例、体质指数、多数病史、血小板和血红蛋白等均无明显差异(均为P>0.05),但两组的晕厥、血压、心率、动脉氧分压、肌钙蛋白I、B型利钠肽和D-二聚体水平均有显著差异(均为P<0.05)。随访中,109例(62.6%)死亡,在出院后1、3、6、12个月和>12个月,分别死亡22例(20.2%)、28例(25.7%)、25例(22.9%)、20例(18.9%)和14例(12.8%)。APE组死亡47例(81.0%),非APE组死亡62例(53.4%),两组间死亡率有显著性差异(P<0.05)。Kaplan-Meier生存分析显示两组的中位生存时间有显著性差异(6.4个月比11.7个月,P<0.05)。多因素logistic回归分析显示,高龄(OR=1.571,95%CI:1.247~1.980)、肺癌Ⅲ~Ⅳ期(OR=3.117,95%CI:1.218~7.977)、手术(OR=2.054,95%CI:1.105~3.818)和深静脉置管(OR=1.651,95%CI:1.073~2.540)是影响APE的危险因素(均为P<0.05)。结论APE合并肺癌患者预后差,高龄、肺癌Ⅲ~Ⅳ期、手术和深静脉置管是影响APE的危险因素。
Objective To evaluate the clinical features,prognosis and risk factors of pulmonary thromboembolism in patients with lung cancer complicated with acute pulmonary embolism(APE).Methods A total of 58 patients with APE and lung cancer admitted in Beijing Shijitan Hospital between January 2010 to December 2017 were retrospective enrolled as the APE group and 116 lung cancer patients with similar age and gender admitted at the same time without APE were in non-APE group.We analyzed the basic and follow-up clinical data.Kaplan-Meier survival analysis and log-rank test was used to assess the median survival time,and univariate and multivariate logistic analysis was used to evaluate the risk factors for APE.Results 174 patients with a mean age of 51.9±18.3 years were enrolled.Baseline characteristics,such as age,male ratio,BMI,medical history,platelet counts,hemoglobin were similar between the two groups(P>0.05).However,syncope,blood pressure,heart rate,PaO 2,cardiac troponin I,BNP and D-Dimer were significantly different between the two groups(P<0.05).During the follow-up,109 patients died(62.6%),of which 47 patients were in the APE group(81.0%)and 62 were in the non-APE group(53.4%).Kaplan-Meier survival analysis showed significant difference in median survival time(P<0.05)between the two groups(P>0.05).Multivariate logistic regression analysis showed that advanced age,tumor stagesⅢ-Ⅳ,surgery and deep vein catheterization were risk factors for APE(all P<0.05).Conclusions Lung cancer patients complicated with APE have higher risk of mortality.Advanced age,tumor stagesⅢ-Ⅳ,surgery and deep vein catheterization are risk factors for APE.
作者
那文娟
段燕芳
Na Weijuan;Duan Yanfang(Department of Respiratory&Critical Care Medicine,Beijing Shijitan Hospital,Capital Medical University,Beijing 100730,China)
出处
《中国心血管杂志》
2019年第5期439-443,共5页
Chinese Journal of Cardiovascular Medicine
关键词
急性肺血栓栓塞
肺癌
预后
危险因素
Acute pulmonary embolism
Lung cancer
Prognosis
Risk factor
