摘要
目的探究血清环氧化酶-2(COX-2)、α2-巨球蛋白(α2-MG)水平与老年肺癌肺切除术后急性呼吸衰竭间的关系。方法本研究为队列研究,选取2019年5月至2021年5月聊城市第三人民医院胸外科收治的108例老年肺癌肺切除患者,男68例,女40例,年龄(72.15±13.15)岁,年龄范围为60~85岁。根据患者肺切除术后是否发生急性呼吸衰竭,将患者分为衰竭组(n=21)与未衰竭组(n=87)。采用倾向性的评分匹配模型,衰竭组匹配成功的20例患者为匹配衰竭组,未衰竭组匹配成功的20例患者为匹配未衰竭组。术后即刻采集患者外周静脉血,检测血清COX-2及α2-MG水平,分析术后即刻血清COX-2及α2-MG水平与急性呼吸衰竭之间的关系。结果倾向性评分匹配前,衰竭组患者肺切除范围与未衰竭组比较,差异有统计学意义(P<0.05),倾向性评分匹配后,两组患者性别、年龄、体质量指数、肺切除范围、肿瘤直径、病理分型、术前合并呼吸系统疾病史、吸烟史比较,差异均无统计学意义(P>0.05)。匹配衰竭组术后即刻血清COX-2水平[(146.99±36.52)μg/ml]显著高于匹配未衰竭组[(121.14±30.15)μg/ml],α2-MG水平[(126.59±23.65)μg/ml]显著低于匹配未衰竭组[(269.64±29.68)μg/ml],差异有统计学意义(P<0.05)。描绘受试者操作特征(ROC)曲线结果发现,术后即刻COX-2及α2-MG在预测老年肺癌肺切除术后急性呼吸衰竭中均具有一定价值,COX-2联合α2-MG应用可有效提高单独应用时的效能。结论COX-2与α2-MG在预测肺切除后急性呼吸衰竭中均具有一定的效能。
Objective To investigate the relationship of serum cyclooxygenase-2(COX-2)and alpha 2-macroglobulin(α2-MG)levels with acute respiratory failure in elderly lung cancer patients after pneumonectomy.Methods This study was a cohort study,from May 2019 to May 2021,a total of 108 elderly patients with lung cancer who were admitted to the department of Thoracic Surgery of Liaocheng Third People′s Hospital were selected,including 68 males and 40 females,aged(72.15±13.15)years old,ranging from 60 to 85 years old.According to whether acute respiratory failure occurred after pneumonectomy,the patients were divided into failure group(n=21)and non-failure group(n=87).Using the tendentious scoring matching model,20 patients who matched successfully in the failure group were the matched failure group,and 20 patients who matched successfully in the non-failure group were the matched non-failure group.Immediately after the operation,the patient′s peripheral venous blood was collected,and the serum COX-2 andα2-MG level were determined,the relationship between serum COX-2 andα2-MG levels and acute respiratory failure was analyzed.Results Before the propensity score match,there was a statistically significant difference in the range of lung resection between the failure group and the non-failure group(P>0.05).After the propensity score match,there was no statistically significant difference between the two groups in gender,age,body mass index,range of lung resection,tumor diameter,pathological classification,preoperative history of respiratory diseases,and smoking history(P<0.05).Serum COX-2 level in matched failure group immediately after operation[(146.99±36.52)μg/ml]was significantly higher than that of matched non-failure group[(121.14±30.15)μg/ml],α2-MG[(126.59±23.65)μg/ml]was significantly lower than that of matched non-failure group[(269.64±29.68)μg/ml],the difference was statistically significant(P<0.05).The results of describing the subject′s work characteristic curve(ROC)showed that COX-2 andα2-MG has c
作者
王亮
于鹏
王建
肖静
张家齐
Wang Liang;Yu Peng;Wang Jian;Xiao Jing;Zhang Jiaqi(Department of thoracic surgery,Liaocheng Third People′s Hospital,Liaocheng 252000,China;Department of Thoracic Surgery,Liaocheng Chiping District People′s Hospital,Liaocheng 252100,China)
出处
《中国临床实用医学》
2022年第6期32-36,共5页
China Clinical Practical Medicine
基金
山东省科学技术成果课题(鲁科成评字[2022]第186号)。
关键词
老年肺癌
肺切除
术后急性呼吸衰竭
血清环氧化酶-2
α2-巨蛋白
Lung cancer in the elderly
Pneumonectomy
Postoperative acute respiratory failure
Cyclooxygenase-2
Alpha 2-macroglobulin
