肺癌患者急性缺血性卒中的危险因素

Risk factors for acute ischemic stroke in patients with lung cancer

目的探讨肺癌患者急性缺血性卒中的危险因素。方法回顾性纳入2019年7月至2021年8月期间首都医科大学附属北京友谊医院收治的肺癌患者,收集患者人口统计学和基线临床资料。根据是否发生急性缺血性卒中,分为病例组和对照组。结果根据倾向匹配评分法从130例肺癌患者中纳入病例组26例,对照组104例。两组年龄、肿瘤分期、肺癌是否发生转移、肺癌治疗方法、高血压、糖尿病、高脂血症、心房颤动、饮酒、舒张压、收缩压、血红蛋白、甘油三酯和鳞状细胞癌相关抗原(squamous cell cacinoma associated antigen,SCC)差异有统计学意义(P均<0.05)。多变量logistic回归分析显示,年龄较大[优势比(odds ratio,OR)1.087,95%置信区间(confidence interval,CI)1.063~1.211;P=0.007]、肺癌治疗方法(OR 1.698,95%CI 1.139~2.532;P=0.009)、高血压(OR 5.647,95%CI 1.921~16.597;P=0.002)、糖尿病(OR 3.082,95%CI 21~16.597;P=0.046)、高脂血症(OR 5.163,95%CI 1.020~9.311;P=0.002)、心房颤动(OR 5.105,95%CI 1.852~14.39;P=0.006)、饮酒(OR 0.30,95%CI 0.123~0.733;P=0.008)、舒张压(OR 1.032,95%CI 0.123~0.733;P=0.022)、收缩压(OR 1.032,95%CI 1.003~1.061;P=0.031)、血红蛋白(OR 1.358,95%CI 0.985~1.871;P=0.042)和SCC(OR 1.535,95%CI 1.069~2.204;P=0.02)是肺癌患者发生急性缺血性卒中的独立危险因素。结论肺癌相关缺血性卒中在高龄患者中多见,且此类患者血红蛋白、甘油三酯和SCC水平较高。年龄、肺癌治疗方法、常见血管危险因素、血红蛋白和SCC是肺癌患者急性缺血性卒中的潜在危险因素。

Objective To investigate the risk factors of acute ischemic stroke in patients with lung cancer.Methods Patients with lung cancer admitted to Beijing Friendship Hospital,Capital Medical University from July 2019 to August 2021 were retrospectively included.The demographics and baseline clinical data of the patients were collected.According to whether acute ischemic stroke had occurred,the patients were divided into a case group and a control group.Results According to the propensity matching score method,26 patients with lung cancer were included in the case group and 104 in the control group.There were significant differences in age,tumor staging,metastasis and treatment of lung cancer,hypertension,diabetes,hyperlipidemia,atrial fibrillation,alcohol consumption,diastolic blood pressure,systolic blood pressure,hemoglobin,triglyceride and squamous cell carcinoma associated antigen(SCC)between the two groups(all P<0.05).Multivariate logistic regression analysis showed that older individuals(odds ratio[OR]1.087,95%confidence interval[CI]1.063-1.211;P=0.007),lung cancer treatment(OR 1.698,95%CI 1.139-2.532;P=0.009),hypertension(OR 5.647,95%CI 1.921-16.597;P=0.002),diabetes(OR 3.082,95%CI 1.020-9.311;P=0.046),hyperlipidemia(OR 5.163,95%CI 1.020-9.311;P=0.002),atrial fibrillation(OR 5.105,95%CI 1.852-14.39;P=0.006),alcohol consumption(OR 0.30,95%CI 0.123-0.733;P=0.008),diastolic blood pressure(OR 1.032,95%CI 0.123-0.733;P=0.022),systolic blood pressure(OR 1.032,95%CI 1.003-1.061;P=0.031),hemoglobin(OR 1.358,95%CI 0.985-1.871;P=0.042),and SCC(OR 1.535,95%CI 1.069-2.204;P=0.02)were the independent risk factors for acute ischemic stroke in patients with lung cancer.Conclusions Lung cancer related ischemic stroke is more common in elderly patients,and such patients have higher levels of hemoglobin,triglycerides,and SCC.Age,lung cancer treatment,common vascular risk factors,hemoglobin,and SCC are the potential risk factors for acute ischemic stroke in patients with lung cancer.