血清白蛋白检测联合6 min步行试验对肺癌患者肺叶切除术后肺部并发症的预测价值

Predictive value of serum albumin detection combined with 6-minute walking distance for postoperative pulmonary complications after lobectomy in patients with lung cancer

目的:探讨血清白蛋白(ALB)检测联合6 min步行试验(6MWD)对肺癌患者肺叶切除术后肺部并发症的预测价值。方法:选取行肺叶切除术的肺癌患者125例为研究对象,按照术后是否发生肺部并发症分为肺部并发症组(n=32例)与无肺部并发症组(n=93例)。采集两组患者的一般资料,应用Logistic回归分析6MWD与ALB和术后肺部并发症的关系,并以受试者工作特征(ROC)曲线评价6MWD与ALB对术后肺部并发症的预测价值。结果:与无肺部并发症组比较,肺部并发症组慢性阻塞性肺疾病(COPD)、糖尿病病史比例较高,呼吸峰流速(PEF)、6MWD与ALB较低(均P<0.05)。Logistic回归分析显示低6MWD、低水平ALB是肺癌患者肺叶切除术后肺部并发症的独立危险因素。6MWD、ALB检测预测术后肺部并发症的ROC曲线下面积(AUC)分别为0.784和0.718,灵敏度分别为82.10%和75.45%,特异度分别为72.94%和76.27%。最佳诊断值分别为402.61 m和34.20 g/L。两者联合预测的AUC为0.875,明显高于各单项预测价值(均P<0.05)。结论:低6MWD、低水平ALB可能是肺癌患者肺叶切除术后肺部并发症的独立危险因素,两者联合评估能够显著提高术后肺部并发症的预测能力,为临床医师评估术后肺部并发症提供了一个较为可靠的手段。

Objective:To explore the predictive value of serum albumin(ALB)combined with 6-minute walking distance(6 MWD)for lung cancer patients with pulmonary complications after lobectomy.Methods:A total of 125 patients with lung cancer who underwent lobectomy were selected and divided into pulmonary complications group(32 cases)and non-pulmonary complications group(93 cases)according to whether or not postoperative pulmonary complications occurred.The general clinical data of the two groups were collected,and the relationship between 6 MWD,ALB and postoperative pulmonary complications was analyzed by Logistic regression.The predictive value of 6 MWD and ALB for postoperative pulmonary complications was evaluated by ROC curve.Results:Compared with non-pulmonary complications group,the proportion of chronic obstructive pulmonary disease(COPD)and diabetes mellitus in pulmonary complications group was higher,and the peak respiratory velocity(PEF),6 MWD and ALB were lower(all P<0.05).Logistic regression analysis showed that low 6 MWD and low ALB level were independent risk factors for pulmonary complications after lobectomy.The AUC of 6 MWD and ALB in predicting postoperative pulmonary complications were 0.784 and 0.718,with sensitivity of 82.10%and 75.45%and specificity of 72.94%and 76.27%,respectively.The best diagnostic values were 402.61 m and 34.20 g/L,respectively.The AUC of the combined prediction was 0.875,which was significantly higher than the single prediction value(all P<0.05).Conclusion:Low 6 MWD and low ALB level may be independent risk factors of pulmonary complications in patients with lung cancer after lobectomy.Combined evaluation of them can significantly improve the prediction ability of postoperative pulmonary complications and provide a reliable means for clinicians to evaluate postoperative pulmonary complications.