肺癌合并肺栓塞的临床预后及其相关危险因素分析

摘要

Objective To investigate the clinical prognosis of lung cancer complicated with pulmonary em-bolism (PE) and the associated risk factors. Methods Fifty-seven patients with lung cancer complicated with pulmo-nary embolism (lung cancer+PE group) and 57 patients of lung cancer (pure lung cancer group) in our hospital from November 2010 to February 2012 were enrolled in the study. The clinical data of the two groups were analyzed by uni-variate, multivariate analysis, and clinical prognosis was evaluated by Kaplan-Meier survival analysis. Results Uni-variate analysis showed that complications, pathological type, TNM stage, central venous catheterization, D-dimer were correlated with lung cancer complicated with PE (P<0.05). Significant variables in univariate analysis further suf-fered logistic regression analysis, which showed that pathological type, TNM stage, D-dimer were the associated risk factors of lung cancer complicated with pulmonary embolism (OR=4.223, 2.357, 2.957). The survival rates at 3 months, 6 months, 12 months were 40.35%, 24.56%, 15.79%in lung cancer+PE group and 59.65%, 40.35%, 26.32%in pure lung cancer group. Kaplan-Meier survival analysis showed that the median survival time in the two groups were 9.4 months and 21.5 months, respectively. Log-rank test showed that the difference was statistically significant (χ2=5.308, P=0.021). Conclusion The clinical prognosis of patients with lung cancer complicated with pulmonary embolism is significantly poorer than that of patients with lung cancer. The independent risk factors mainly include adenocarcino-ma, high TNM stage and high D-dimer level.%目的：探讨肺癌合并肺栓塞的临床预后及其相关危险因素。方法选取2010年11月至2012年2月我院收治的肺癌合并肺栓塞患者57例(肺癌+PE组)和单纯肺癌患者57例(单纯肺癌组)。对两组患者的临床资料进行单因素、多因素分析，并通过Kaplan-Meier生存分析评价患者的临床预后。结果单因素分析结果显示，合并症、病理类型、TNM分期、中心静脉穿刺置管、D-二聚体与肺癌合并肺塞栓具有相关性(P<0.05)。对单因素分析中的显著性变量进行Logistic回归分析，结果显示病理类型、TNM分期、D-二聚体是肺癌合并肺栓塞的相关危险因素(OR=4.223、2.357、2.957)。肺癌+PE组3个月、6个月、12个月的生存率分别为40.35%、24.56%、15.79%；单纯肺癌组则分别为59.65%、40.35%、26.32%。Kaplan-meier生存分析显示，肺癌+PE组、单纯肺癌组的中位生存时间分别为9.4个月、21.5个月，Log-rank检验显示两组差异具有统计学意义(χ2=5.308，P=0.021)。结论肺癌合并肺栓塞患者的临床预后明显低于单纯肺癌患者，其独立危险因素主要包括腺癌、高TNM分期及高D-二聚体水平。