心肺危险指数(CPRI)在预计肺癌手术近期预后中的价值

Value of cardiopulmonary risk index in predicting postoperative short-term prognosis in patients with lung cancer

目的 探讨心肺危险指数 (CPRI)在预计肺癌切肺术后近期预后中的价值。方法 选择 1999年上海胸科医院胸外科所有肺癌肺切除患者 ,从术前临床资料中计算出心脏危险指数 (CRI)和肺危险指数(PRI) ,二者相加为心肺危险指数 (CPRI) ,分析CPRI在预计肺癌肺切除手术风险中的价值。结果 共行肺切除术 62 5例。术后 49例 (7.8% )发生各种并发症 (包括 8例术后 3 0天内死亡 )。全组CRI、PRI和CPRI范围分别为 1～ 3级、0～ 5级和 1～ 7级。CPRI <4级 489例 ,≥ 4级 13 6例。以CPRI≥ 4级为标准 ,预计肺癌肺切除手术风险的敏感性为 75 .7% ,特异性为 82 .8% ,准确率为 82 .2 %。结论 CPRI可作为肺癌患者肺切除术前预计手术近期预后的一项重要指标 ,但并不能完全预测切肺术后的风险 。

Objective To determine the value of preoperative cardiopulmonary risk index (CPRI) in predicting the short term prognosis after lung resection in patients with lung cancer. Methods Preoperative clinical data were used to generate a cardiac risk index (CRI) and a pulmonary risk index (PRI). And the value of cardiopulmonary risk index (CPRI) consisting of CRI and PRI in predicting postoperative prognosis was estimated in patients who underwent lung resection at Shanghai Chest Hospital in 1999. Results A total of 625 consecutive patients were studied. Postoperative complications occurred in 49 patients (7.8%), including 8 deaths within 30 days of operation. In the total group, CRI, PRI and CPRI scores ranged from 1 to 3, 0 to 5 and 1 to 7, respectively. There were 489 patients with CPRI<4, and 136 with CPRI≥4. Using CPRI≥4 as a threshold for predicting postoperative complications, the sensitivity, specificity and accuracy rate were 75.5%, 82.8% and 82.2% respectively. Conclusion The preoperative CPRI is one of the important indexes in predicting the short term postoperative prognosis for patients with lung cancer. However, it can not completely predict all of postoperative risks, and should be used together with other factors.