非小细胞肺癌合并静脉血栓栓塞症危险因素分析

摘要

目的分析非小细胞肺癌(non-small cell lung cancer,NSCLC)合并静脉血栓栓塞症(venous thromboem-bolism,VTE)的危险因素,为防治NSCLC患者并发VTE提供参考依据.方法回顾性分析本院2013年7月至2016年7月收治的274例NSCLC患者的临床资料,按照VTE发生情况将患者纳入VTE组和非VTE组,比较两组患者一般资料、血清学指标及凝血状态的差异,将存在统计学差异的因素纳入多因素Logistic回归分析,总结影响NSCLC患者合并VTE的危险因素.结果274例患者中,181例患者发生VTE,VTE发生率为66.06%.两组患者年龄、性别、体重指数、吸烟史、饮酒史、血型、病理类型、美国东部协作肿瘤组(Eastern Cooperative Oncology Group,ECOG)体能状态评分、治疗方案、肿瘤分期比较均有显著差异(P<0.05).多因素Logistic回归分析显示,年龄≥60岁、腺癌、ECOG体能状态评分≥2分、化疗、总胆固醇水平>5.2 mmol/L、甘油三酯水平>1.7 mmol/L及D-二聚体水平≥0.5 mg/L是NSCLC患者合并VTE的独立危险因素(P<0.05).结论NSCLC患者VTE的发生率较高,且与年龄、体力状态、治疗方案、血脂水平及凝血功能密切相关,可据此评价患者VTE发生风险并予以对症干预,降低VTE发生率.%Objective To explore the risk factors of venous thromboembolism (VTE) in non-small cell lung cancer (NSCLC) patients, and to provide reference for the prevention and treatment of VTE in patients with NSCLC. Method 274 patients with NSCLC in our hospital from July 2013 to July 2016 were divided into VTE group and non-VTE group according to the occurrence of VTE. The clinical data, serum parameters and blood coagulation factors between the two groups of patients were compared to summary the risk factors of VTE in NSCLC patients. Result In 274 patients, the incidence of VTE was 66.06% (181/274). There were significant differences between the two groups in age, sex, body mass index, smoking history, drinking history, blood type, pathological type, Eastern Cooperative Oncology Group (ECOG) score, treatment regimen and staging of the tumor (P<0.05). Logistic regression analysis showed that age≥60 years old, adenocarcinoma, ECOG score≥2 points, chemotherapy, total cholesterol level>5.2 mmol/L, triglyceride level>1.7 mmol/L and D-Dimer level≥0.5 mg/L were the independent risk factors for NSCLC patients complicated with VTE (P<0.05). Conclusion The incidence of VTE in patients with NSCLC is high and which is closely related with age, physical condition, blood lipid levels and blood coagulation function. The risk of VTE can be evaluated and the symptomatic intervention should be done, in order to reduce the incidence rate of VTE.