放射性肺炎121例临床分析

Analysis of 121 Cases of Radiation Pneumonitis

目的分析放射性肺炎的发病率及治疗情况。方法1998年1月至2003年12月接受胸部放疗的1793例患者中，共有121例被诊断为放射性肺炎，分析不同原发病种间放射性肺炎的发病率，根据住院时间以2001年7月1日为界分为两组。比较不同时问段放射性肺炎发病率并分析其原因。将中重度放射性肺炎的患者依据糖皮质激素使用时间的不同分为2组，一组的使用时间在2个月以下，另一组在2个月以上。结果2001年-2003年放射性肺炎的发病率高于1998年-2001年（P〈0．05）。多因素分析，原发病种类、放疗剂量、辅助化疗是对放射性肺炎发生有影响的危险因素。中重度放射性肺炎的治疗过程中糖皮质激素维持量的使用时间在2个月以上组放射性肺炎的复发率低于使用时间在2个月以下组（P〈0．05）。结论 原发病种类、放疗剂量、辅助化疗是对放射性肺炎发生有影响的危险因素。中重度放射性肺炎的治疗过程中糖皮质激素的的使用时间应在2个月以上。

Objective To analyze the morbidity and treatment method of radiation pneumonitis. Methods From Jan 1998 to Dec 2003,121 of 1793 patients in our hospital who received thoracic radiotherapy have been diagnosed as radiation pneumonitis. We analyzed the morbidity of radiation pneumonitis in different primary diseases. We divided the patients into two groups according to the admission date： one group was admisioned to our hospital before July 1 th,2001, the other was after that day. We compared the risks of radiation pneumonitis in the two groups and try to find the reasons and evaluate the curative effect of radiation pneumonitis. The patients with moderate-to-severe radiation pneumonitis were divided into two groups according to the different time that corticosteroid therapy persists： longer than 2 months, and shorter than that. Results The morbidity of radiation pneumonitis between year 2001 -2003 are higher than that of 1998 - 2001 （ P 〈 0.05）. Multi-factor analysis showed that the type of primary disease, radiotherapy dose and adjuvant chemotherapy are the risk factors of radiation pneumonitis. The recurrence rate in the group which received corticosteroid therapy more than 2 months was lower than the other one （ P 〈 0.05 ）. Conclusion The morbidity of radiation pneumonitis has increased recently. Type of the primary disease, radiotherapy dose and adjuvant chemotherapy are the risk factors of radiation pneumonitis. Corticosteroid therapy for the moderate-to-severe radiation pneumonitis patients should persists for more than 2 months.