肺癌合并慢性阻塞性肺疾病患者放疗前后肺功能变化的研究

Lung Function Changes in Patients with Lung Cancer Complicated with Chronic Obstructive Pulmonary Disease Before and After Radiotherapy

目的:探讨肺癌合并慢性阻塞性肺疾病患者放疗前后肺功能的变化情况,为该类患者放疗的安全性评估提供依据。方法:选取我院2010年3月-2017年3月间收治的肺癌合并COPD患者122例患者作为研究对象,分别比较患者放疗前、放疗后2周、放疗后4周、放疗后1月、放疗后2月、放疗后3月的肺功能情况,主要测定指标包括FEV1/FVC、FEV1%、FVC、MVV和MEF等指标。结果:放疗结束时肺功能指标相比放疗前略微有改善,但无统计学差异,而放疗2周后患者FEV1%、FVC、MVV和MEF等指标开始下降,且相比放疗前有统计学差异,放疗后1月、2月、3月患者FEV1%、FVC、MVV和MEF指标呈现逐渐下降的趋势,而FEV1/FVC呈现逐渐上升的趋势,相比放疗前均具有统计学差异。结论:对于肺癌合并COPD患者,放射治疗短期内对患者肺功能无影响,但中长期对患者肺功能影响较大,临床需引起重视。

Objective: To investigate the changes of lung function in patients with lung cancer complicated with chronic obstructive pulmonary disease before and after radiotherapy, so as to provide the basis for the safety evaluation of radiotherapy for this type of patients. Method:Lung cancer patients with COPD in our hospital from March 2010-March 2017 year from 122 patients as the research object, the patients were compared 2 weeks before and after radiotherapy and 4 weeks after radiotherapy, 1 month after radiotherapy, 2 months after radiotherapy, 3 months after radiotherapy for the pulmonary function, the major indexes including FEV1/FVC,FEV1%, FVC, MVV and MEF index. Results: At the end of radiotherapy of lung function index than before radiotherapy slightly improved, but the difference was not statistically significant, and after 2 weeks of radiotherapy in patients with FEV1%, FVC, MVV and MEF index began to decline, and the difference was statistically significant before radiotherapy, 1,2,3 months after radiontherapy,FVC, MVV and FEV1% in patients with MEF index showed a gradual decline the trend, while FEV1/FVC increased compared to before radiotherapy was statistically significant. Conclusion: For patients with lung cancer combined with COPD, radiotherapy has no effect on lung function in the short term, but has a greater impact on lung function in the medium and long term, and should be paid attention to in clinic.