影响肺癌患者合并肺栓塞的相关危险因素分析

Analysis of related risk factors affecting lung cancer patients with pulmonary embolism

目的探讨肺癌患者合并肺栓塞(PE)的相关危险因素,为临床早期干预提供依据。方法选取丽水市人民医院急诊科2016年1月至2020年8月收治的92例合并PE的肺癌患者为PE组,同时随机选取184例未发生PE的肺癌患者为非PE组;所有患者均进行实验室检查和医学影像学检查,并对患者的临床资料进行调查,采用单因素χ2检验和逐步Logistic回归法筛选影响肺癌合并PE的相关危险因素。结果单因素分析结果显示,两组间病理类型、合并基础疾病、肿瘤分期、肿瘤转移、化疗、中心静脉置管、D-二聚体、血小板计数、伴深静脉血栓和长期卧床等因素比较,差异有统计学意义(P<0.05);而两组间性别、年龄、体质量指数、吸烟史、手术治疗、癌胚抗原和血红蛋白等因素比较,差异无统计学意义(P>0.05)。多因素分析结果显示,影响肺癌合并PE的危险因素包括腺癌(OR=3.629)、合并基础疾病(OR=2.872)、肿瘤分期(OR=4.358)、化疗(OR=3.127)、中心静脉置管(OR=3.377)、D-二聚体(OR=5.613)及伴深静脉血栓(OR=2.977)。结论肺癌合并PE的独立危险因素包括腺癌、合并基础疾病、高肿瘤分期、化疗治疗、中心静脉置管、高D-二聚体水平、伴有深静脉血栓等,应根据这些独立危险因素,早期进行高危因素筛查、管理和干预,降低肺癌患者的PE发生率,从而改善肺癌患者的预后。

Objective To explore the risk factors of lung cancer patients with pulmonary embolism(PE),and to provide evidence for early clinical intervention.Methods A total of 92 lung cancer patients with PE admitted to the Emergency Department of Lishui People′s Hospital from January 2016 to August 2020 were selected as the PE group,and 184 lung cancer patients without PE were randomLy selected as the non-PE group.All patients underwent laboratory examinations and medical imaging examinations.The clinical data of the patients were investigated.The single factorχ2 test and stepwise Logistic regression were used to screen the relevant risk factors that affect lung cancer with PE.Results Univariate analysis showed statistically significant differences in pathological types,combined underlying diseases,tumor staging,tumor metastasis,chemotherapy,central venous catheterization,D-dimer,platelet count,deep vein thrombosis,and long-term bed rest between the two groups(P<0.05).There was no statistically significant difference in factors such as gender,age,body mass index,smoking history,surgical treatment,carcinoembryonic antigen,and hemoglobin between the two groups(P>0.05).The results of multivariate analysis showed that the risk factors affecting lung cancer with PE included adenocarcinoma(OR=3.629),combined with underlying disease(OR=2.872),tumor stage(OR=4.358),chemotherapy(OR=3.127),central venous catheterization(OR=3.377),D dimer(OR=5.613),and deep vein thrombosis(OR=2.977).Conclusion The independent risk factors for lung cancer with PE include adenocarcinoma,underlying diseases,high tumor stage,chemotherapy,central venous catheterization,high D-dimer level,and deep vein thrombosis.According to these independent risk factors,early screening,management and intervention of high-risk factors should be carried out to reduce the incidence of PE in lung cancer patients,thereby improving the prognosis of lung cancer patients.