高原地区肺癌患者放疗后发生放射性肺损伤的危险因素

摘要

目的：探讨影响高原肺癌患者发生放射性肺损伤的危险因素。方法：采用回顾性病例对照研究分析我院183例肺癌患者接受放射治疗后发生 RILI 的危险因素。运用单因素χ2检验和多因素 Logistic 回归分析独立影响因素，Kaplan - Meier 分析比较两组患者的生存情况及血液毒性变化。结果：经单因素分析发现民族、常住地、合并慢性肺炎、合并慢性病和V 20有统计学意义（χ2=8.548、40.539、6.941、8.117、41.79，P <0.05）。多因素分析发现民族、常住地、合并慢性肺炎和 V20是独立的危险因素（P <0.05）。放疗开始对患者的血液变化影响较大，尤其是 WBC 等。生存分析显示对照组中位生存期16个月明显高于病例组11个月（P<0.05）。结论：影响患者发生 RILI 因素很多，应该根据患者基本情况适当调整放射治疗方案，以降低 RILI的发病风险。%Objective:To investigate the risk factors related to lung cancer of radiation - induced lung injury(RI-LI)in plateau area. Methods:Analyzing the risk factors of RILI of 183 lung cancer patients with receiving radiothera-py by retrospective case - control study,to seek independent influencing factors by using single factor χ2 test and mul-tiple factors Logistic analysis and Kaplan - Meier. Results:Single factor analysis found that there were statistically significant with national,local living,merging chronic pneumonia,chronic disease and V20(χ2 = 8. 55,40. 54,6. 94, 8. 12,41. 79,P < 0. 05). Multiple factor Logistic analysis found that the independent risk factors were national,local living,merging chronic pneumonia and V20(P < 0. 05). Radiation therapy was contributed to blood changes greatly, especially WBC. Survival analysis showed that the median survival time with 16 months of control group has statistical-ly significantly better than 11 months of case group(P < 0. 05). Conclusion:There were many influencing factors of RILI,and radiation treatment plan should be adjusted according to the basic situation of lung cancer patients,in order to reduce the risk of RILI.