肺癌患者并发静脉血栓栓塞症的危险因素分析

Analysis of risk factors of venous thromboembolism in patients with lung cancer

目的分析肺癌患者并发静脉血栓栓塞症(VTE)的危险因素。方法收集2014年1月至2017年10月广西医科大学第一附属医院收治的2949例肺癌患者的临床资料,以是否发生VTE分为VTE组(59例)和非VTE组(2890例),通过比较两组间的性别、年龄、身体质量指数(BMI)、手术、化疗、吸烟、高血压、糖尿病、冠心病、脑梗死等因素,分析肺癌患者发生VTE的相关危险因素。在VTE组(59例)中,再以是否发生肺栓塞(PE)分为PE组(18例)和非PE组(41例),两组进行对比,分析肺癌患者合并深静脉血栓形成(DVT)后发生PE的危险因素。结果单因素分析显示手术、化疗、病理类型、肺癌分期及冠心病在VTE组与非VTE组间差异具有统计学意义(P均<0.05),Logistic多因素回归分析显示化疗、腺癌、肺癌分期Ⅳ期、冠心病在VTE组与非VTE组间差异具有统计学意义(P均<0.05);BMI在PE组与非PE组间差异具有统计学意义(P<0.05)。结论冠心病、手术、化疗、病理类型、肺癌分期与肺癌患者发生VTE密切相关,冠心病、化疗、腺癌、肺癌分期Ⅳ期可能是肺癌患者发生VTE的独立危险因素;BMI≥25 kg/m2可能是肺癌患者并发DVT后发生PE的重要危险因素之一。

Objective To analyze the risk factors of venous thromboembolism(VTE)in patients with lung cancer.Methods A total of 2949 patients with lung cancer admitted to the First Affiliated Hospital of Guangxi Medical University from January 2014 to October 2017 were collected.The cases with VTE were assigned to the VTE group(n=59),and those without VTE were in the non-VTE group(n=2890).First,for VTE and non-VTE groups,gender,age,body mass index(BMI),surgery,chemotherapy,smoking,hypertension,diabetes,coronary heart disease,cerebral infarction and other factors were used to analyze the risk factors for VTE.Next,for VTE group(n=59),patients were sub-classified in pulmonary embolism(PE)group(n=18)and non-PE group(n=41)according to PE history.The two groups were compared to analyze the risk factors for PE in lung cancer patients with deep vein thrombosis(DVT).Results Univariate analysis showed that there were significant differences between the VTE group and the non-VTE group in surgery,chemotherapy,pathological type,lung cancer staging and coronary heart disease(P<0.05).Logistic multivariate regression analysis indicated significant differences between the VTE group and the non-VTE group in chemotherapy,adenocarcinoma and lung cancer stageⅣ(P<0.05).The difference of BMI between the PE group and the non-PE group was statistically significant(P<0.05).Conclusion Coronary heart disease,surgery,chemotherapy,pathological type and lung cancer stage are closely related to VTE in patients with lung cancer.Coronary heart disease,chemotherapy,adenocarcinoma and stage IV of lung cancer may be independent risk factors for VTE in patients with lung cancer.BMI≥25 kg/m2 is one of the significant risk factors for PE in lung cancer patients with DVT.