文章摘要
洪 娇,程弯弯,王艳丽,金 宇,黄 文,王 虹,解卫平.96例肺腺癌伴发静脉血栓栓塞症危险因素分析[J].南京医科大学学报,2018,(9):1234~1239
96例肺腺癌伴发静脉血栓栓塞症危险因素分析
Analysis of risk factors for 96 cases of pulmonary adenocarcinoma with venous thromboembolism
投稿时间:2018-03-30  
DOI:10.7655/NYDXBNS20180913
中文关键词: 肺腺癌  静脉血栓栓塞症  肺血栓栓塞症  深静脉血栓形成
英文关键词: lung adenocarcinoma  venous thromboembolism  pulmonary thromboembolism  deep vein thrombosis
基金项目:江苏省卫生厅重点项目(H201601);国家科技重大专项(2018ZX10722301?002)
作者单位
洪 娇 南京医科大学第一附属医院呼吸与危重症学科江苏 南京 210029 
程弯弯 南京医科大学第一附属医院呼吸与危重症学科江苏 南京 210029 
王艳丽 南京医科大学第一附属医院呼吸与危重症学科江苏 南京 210029 
金 宇 南京医科大学第一附属医院呼吸与危重症学科江苏 南京 210029 
黄 文 南京医科大学第一附属医院呼吸与危重症学科江苏 南京 210029 
王 虹 南京医科大学第一附属医院呼吸与危重症学科江苏 南京 210029 
解卫平 南京医科大学第一附属医院呼吸与危重症学科江苏 南京 210029 
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中文摘要:
      目的:研究肺腺癌伴发静脉血栓栓塞症(venous thromboembolism,VTE)的危险因素,提高对肺腺癌伴发VTE的认识。方法:回顾分析2012年1月—2016年12月南京医科大学第一附属医院住院的2 930例肺腺癌患者临床资料,发现96例伴发VTE。将伴发VTE肺腺癌患者纳入VTE组,未发生VTE患者纳入非VTE组,对肺腺癌伴发VTE的危险因素进行分析。结果:96例(3.3%)肺腺癌伴发VTE。VTE患者中,男57例,女39例,平均年龄(60.8±10.1)岁;非VTE组中男1 477例,女1 357例,平均年龄(61.0±10.5)岁。两组比较发现,吸烟、中心静脉置管、合并有慢性肺部疾病、肺腺癌分期的差异有统计学意义(P < 0.05)。多因素Logistic回归分析示肺腺癌Ⅲ~Ⅳ期、合并慢性肺部疾病是肺腺癌伴发VTE的高危因素。96例中,单独发生肺血栓栓塞(pulmonary thromboembolism,PTE)26例(27.1%),单独发生深静脉血栓(deep vein thrombosis,DVT)51例(53.1%),同时存在DVT和PTE 19例(19.8%)。45例PTE患者中,37例(82.2%)出现明显临床症状,8例(17.8%)无明显症状。70例DVT患者中,66例(94.3%)表现为患侧肢体肿胀或疼痛。96例中,71例为肺癌治疗后伴发VTE,0~3个月、3~6个月、6~9个月、9~12个月、>12个月VTE发生例数分别为37、8、8、4、14例。截至随访时间,52例(54.17%)死亡,伴发VTE的中位生存时间为5个月。结论:肺腺癌Ⅲ~Ⅳ期、合并有慢性肺部疾病与肺腺癌伴发VTE显著相关。肺腺癌诊断后的前3个月内最容易发生VTE。
英文摘要:
      Objective:To study the risk factors of pulmonary adenocarcinoma with venous thromboembolism(VTE),and to improve the understanding of lung adenocarcinoma with VTE. Methods:The clinical data of 2 930 patients with lung adenocarcinoma admitted to the First Affiliated Hospital of NMU from January 2012 to December 2016 were retrospectively analyzed,and 96 cases were found to have VTE. Patients with VTE were included in the VTE group. Patients without VTE were included in the non?VTE group. The risk factors of VTE in lung adenocarcinoma were analyzed. Results:Among the 2 930 cases of lung adenocarcinoma,96 cases/2 930 cases(3.3%)were associated with VTE. In the VTE group,there were 57 males and 39 females,with an average age of (60.8 ± 10.1)years. In the non?VTE group,there were 1 477 males and 1 357 females,the average age was(61.0 ± 10.5)years old. There were signicant differences in smoking,central venous catheterization,chronic pulmonary diseases and stage of lung adenocarcinoma between two groups(P < 0.05). Multiple factor analysis suggested that the chronic pulmonary disease and Ⅲ~Ⅳ stage of lung adenocarcinoma were high risk factors for lung adenocarcinoma associated with VTE. Of the 96 patients with VTE group,26 cases(27.1%)occurred in pulmonary thromboembolism(PTE)only,51 cases(53.1%)occurred in deep vein thrombosis(DVT)only,and 19 cases(19.8%)occurred in PTE and DVT. Among 45 patients with PTE,37 cases(82.2%)showed obvious clinical symptoms,and 8 cases(17.8%)had no obvious symptoms. Among 70 patients with DVT,66 cases(94.3%)showed swelling or pain on the affected side. Seventy?one patients in VTE group were accompanied by VTE after treatment of lung cancer. For 0?3 months,3~6 month,6?9 months,9?12 months and >12 months,the number of VTE cases was 37,8,8,4 and 14,respectively. At the end of follow?up,52 cases/96 cases(54.17%)died,and the median survival time of patients with VTE was 5 months. Conclusion:There was a significant correlation between Ⅲ?Ⅳ stage of lung adenocarcinoma,chronic pulmonary disease and lung adenocarcinoma with VTE. VTE was the most likely to occur in the first 3 months of the diagnosis of lung adenocarcinoma.
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