术前V_(1)导联P波终末电势值和肺功能评分对老年非小细胞肺癌术后呼吸衰竭的预测价值

Predictive Value of Preoperative P Terminal Force in Lead V_(1) and Pulmonary Function Score for Postoperative Respiratory Failure in Elderly Patients with Non-small Cell Lung Cancer

[目的]研究术前心电图V1导联P波终末电势值(P terminal force in lead V1,PtfV_(1))和肺功能评分对老年非小细胞肺癌(non-small cell lung cancer,NSCLC)患者术后呼吸衰竭的预测价值。[方法]选取湖南省肿瘤医院2018年9月至2020年12月收治的116例行手术治疗的老年NSCLC患者为研究对象,术前3 d检测PtfV_(1)水平和肺功能评分。根据术后7 d内是否发生呼吸衰竭分为呼吸衰竭组(24例)和非呼吸衰竭组(92例),比较两组患者PtfV_(1)水平、肺功能评分及其他可能影响因素。采用Logistic回归分析影响老年NSCLC患者术后呼吸衰竭的相关因素。绘制受试者工作特征(receiver operating characteristic curve,ROC)曲线,分析PtfV_(1)水平、肺功能评分对老年NSCLC患者术后呼吸衰竭的预测价值。[结果]Logistic回归分析显示病理分期、术前化疗、PtfV_(1)和肺功能评分均是影响老年NSCLC癌患者术后发生呼吸衰竭的相关因素(P<0.05)。ROC曲线分析显示,PtfV_(1)联合肺功能评分预测老年NSCLC患者术后发生呼吸衰竭的灵敏度、准确率、曲线下面积分别为91.26%、85.97%和0.814,均高于PtfV_(1)(70.31%、68.34%、0.718)、肺功能评分(84.24%、72.64%、0.739)单独预测;但特异度(60.32%)低于PtfV_(1)(85.69%)、肺功能评分(68.39%)单独预测。[结论]PtfV_(1)和肺功能评分是老年NSCLC患者术后发生呼吸衰竭独立危险因素,两者联合检测对老年NSCLC患者术后发生呼吸衰竭具有较高预测价值。

[Objective]To assess the predictive value of P terminal force in lead V1(PtfV1)and pulmonary function score for postoperative respiratory failure in elderly patients with non-small cell lung cancer.[Methods]A total of 116 patients with non-small cell lung cancer who underwent surgical treatment in Hunan Cancer Hospital from September 2018 to December 2020 were enrolled in the study.The PtfV1 level of the patient was measured 3 days before operation,and the pulmonary function score were evaluated.The respiratory failure occurred within 7 days after operation in 24 cases(respiratory failure group)and did not occur in 92 cases(non-respiratory failure group).The level of PtfV1,pulmonary function and other possible influencing factors were compared between two groups.The risk factors of postoperative respiratory failure were analyzed with Logistic regression,the predictive value of PtfV1 level and pulmonary function score for postoperative respiratory failure was evaluated with receiver operating characteristic curve(ROC).[Results]Logistic regression analysis showed that pathological staging,preoperative chemotherapy,PtfV1,and pulmonary function score were the related factors affecting postoperative respiratory failure in elderly patients with non-small cell lung cancer(P<0.05).ROC curve analysis showed that the area under the curve of PtfV1 combined with pulmonary function score in predicting postoperative respiratory failure was higher that that of PtfV1 and pulmonary function score alone(0.814 vs 0.718 vs 0.739),the sensitivity and accuracy were higher than those of PtfV1 and pulmonary function score alone(91.26%vs 70.31%vs 84.24%,85.97%vs 68.34%vs 72.64%),while the specificity of PtfV1 combined with pulmonary function score was lower than that of PtfV1 and pulmonary function score alone(60.32%vs 85.69%vs 68.39%).[Conclusion]PtfV1 and pulmonary function score are independent risk factors for postoperative respiratory failure in elderly patients with non-small cell lung cancer.The combination of the PtfV1 and pulmonary function score has a high predictive value for postoperative respiratory failure in elderly patients with non-small cell lung cancer.