晚期肺癌患者合并肺部感染的特点及相关因素分析

Analysis of Characteristics and Related Factors of Advanced Lung Cancer with Pulmonary Infection

目的 探讨晚期肺癌患者合并肺部感染的特点及相关因素,为临床治疗提供指导。方法 回顾性分析2014年1月至2016年12月243例晚期肺癌住院患者的临床资料,描述感染特点及对感染的相关因素进行单因素及多因素Logistic回归分析。结果243例晚期肺癌患者合并肺部感染78例,感染率32.01%,以革兰氏阴性菌和真菌为主;单因素分析显示,糖尿病、呼吸系统疾病、放疗、化疗、年龄≥65岁、吸烟指数≥400年支、中性粒细胞数目≤2×109/L、血浆白蛋白含量≤35g/L、血红蛋白含量≤110g/L、ECOG评分>2与晚期肺癌患者合并肺部感染相关(P<0.05),其中对不同病理类型肺癌之间的感染率作出了比较;多因素Logistic回归分析显示,糖尿病、呼吸系统疾病、放疗、化疗、年龄≥65岁、中性粒细胞数目≤2×109/L、血浆白蛋白含量≤35g/L、ECOG评分>2为晚期肺癌患者合并肺部感染的独立危险因素(P<0.05)。结论晚期肺癌患者更容易合并肺部感染,老年患者感染率更高,且有多种影响因素,医护人员在临床工作中应采取针对性的防治措施,减少感染的发生。

Objective To investigate the characteristics and related factors of pulmonary infection in advanced lung cancer patients so as to provide guidance for clinical treatment.Methods Retrospective clinical data of243 advanced lung cancer patients were collected from Jan2014 to Dec2016 in hospital.The characteristics of infections were described,univariate analysis and multivariate logistic regression analysis were performed for the related factors for pulmonary infections.Results The pulmonary infections occurred in 88 of243 patients,with the infection rate of 36.21 %,the predominant pathogens were Gram-negative bacteria and fungi;Univariate analysis indicated that the diabetes,respiratory system disease,radiotherapy,chemotherapy,age no less than 65 years old,smoking index no less than 400,neutrophil content no more than2×10 9/L,albumin content no more than 35g/L,hemoglobin content no more than110g/L,and ECOG score more than2were associated with the concurrent pulmonary infections in the advanced lung cancer patients( P < 0.05),infection rates among different pathological types of lung cancer were compared.Multivariate logistic regression analysis showed that diabetes,respiratory system disease,radiotherapy,chemotherapy,age no less than 65 years old,neutrophil content no more than2×10 9/L,albumin content no more than 35g/L,and ECOG score more than2were the in-dependent risk factors for the pulmonary infections in the advanced lung cancer patients( P < 0.05).Conclusion The advanced lung cancer patients are vulnerable to pulmonary infections,especially older patients,there are a variety of influencing factors which the clinicians should pay high attention to,and moreover,effective measures should be taken to reduce the occurrence of infection.