慢性阻塞性肺疾病合并肺癌临床特征分析

Analysis on the clinical characteristics of chronic obstructive pulmonary disease complicated with lung cancer

目的:探讨与总结慢性阻塞性肺疾病合并肺癌临床特征,为临床诊治两种疾病提供一定的依据。方法:选择2016年1—12月在中国石油乌鲁木齐石油化工总厂职工医院及新疆维吾尔自治区胸科医院住院治疗的COPD合并肺癌患者的53例(COPD合并肺癌组),与同期在该院治疗的82例单纯性COPD患者(单纯COPD组)对比研究。对患者的病例资料进行统计分析,采用肺功能仪检测两组患者的肺功能,检测指标主要有:第一秒用力呼气容积(FEV1)与用力肺活量(FVC)比值(FEV1/FVC)、FEV1预计值的百分比(FEV1%pre)、肺总量(TLC)、残气容积与TLC的比值(RV/TLC)等指标,比较两组肺功能指标的差异。结果:COPD合并肺癌组吸烟及每年吸烟支数≥300支患者的比率明显高于COPD组,经比较差异有统计学意义(P<0.05)。COPD组与COPD合并肺癌组患者均出现咳嗽、咳痰、呼吸困难、胸痛等症状中的一项或多项临床症状。COPD合并肺癌组咯血、胸痛、胸腔积液、消瘦、乏力临床症状的发生率高于COPD组,差异有统计学意义(P<0.05)。COPD合并肺癌组FEV1%pred和TLC明显低于COPD组,差异有统计学意义(P<0.05),其他肺功能项指标,如FEV1/FVC,RV/RC经比较差异无统计学意义(P>0.05)。结论:COPD合并肺癌的临床症状特征不明显,早期较难得到确诊。在COPD合并肺癌的早期发现中,全面定期的检查具有重要的临床意义,确保患者得到有效的治疗,减轻患者的病症。

Objective： To investigate and summarize the clinical features of chronic obstructive pulmonary disease （COPD） complicated with lung cancer, and to provide the evidence for clinical diagnosis and treatment of these two diseases. Methods： Fifty-three COPD patients combined with lung cancer （COPD combined with lung cancer） were enrolled in the hospital of Staff-worker Hospital of Urumqi Petrochemical Subsidiary China National Petroleum and the Chest Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2016. In the same period, 82 patients with simple COPD （COPD group） were also enrolled. FEV1/FVC, FEV1% pre, total lung volume （TLC）, residual volume and TLC ratio （RV/TLC） were compared between the two groups. Results： The rate of smoking 〉1300 per year in COPD combined with lung cancer group was significantly higher than that of patients with COPD, the difference was statistically significant （P〈0.05）. COPD combined with lung cancer group had one or two symptoms such as cough, sputum, dyspnea, chest pain. The incidence of hemoptysis, chest pain, pleural effusion, weight loss in COPD combined with lung cancer group, was higher than COPD group, the difference was statistically significant （P〈0.05）. FEV1% pre and TLC in COPD combined with lung cancer group was significantly lower than COPD group, the difference was statistically significant （P〈0.05）. Other pulmonary function items, such as FEV1/FVC, RV/RC was not statistically significant different between two groups. Conclusion： The clinical symptoms of COPD with lung cancer are not obviously, it is difficult to be early diagnosed. Comprehensive early detection of COPD with lung cancer, comprehensive and regular examinations have important clinical significance, we should ensure that patients receive effective treatment to reduce the patient＇s condition.