肺癌合并中重度低钠血症的预后分析  

Lung cancer associated moderate and severe hyponatremia:an analysis of factors influencing survival and prognosis in 94 lung cancer cases

作　　者：李旭[1] 胡雪晴[1] 张子瑾[1] 别志新 张帅[1] 艾斌[1] 

机构地区：[1]北京医院肿瘤内科,北京100730

出　　处：《中华肿瘤防治杂志》2016年第10期672-676,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的低钠血症是肺癌最常见的电解质紊乱之一，可能是其不良预后因素。本研究旨在探讨不同血钠水平对于肺癌预后的影响及其他可能影响肺癌合并中重度低钠血症的患者生存的预后因素。方法以北京医院2010—08—01—2015—03～01收治的经病理确诊的94例肺癌合并中重度低钠血症患者作为研究对象，收集临床资料。将其分为中度低钠血症组（血钠125～129mmol／L）66例和重度低钠血症组（血钠〈125mmol／L）28例，分析患者生存时间的差异及影响生存的预后因素。结果重度低钠血症较中度低钠血症患者的中位生存时间缩短（123dvs48d，P=0．09）。单因素分析中影响患者生存时间的因素包括血清乳酸脱氢酶升高（中位生存时间43d7AS170d，P〈0．001）、美国东部肿瘤协作组（Eastern Cooperative Oncology Group，ECOG）评分≥2分（中位生存时间48d vs 240d，P〈0．001），以及合并有恶性胸腔积液（中位生存时间60dV5150d，P=0．012）。多因素分析中血钠水平（HR=1．759，P=0．021）、ECOG评分（HR=0．443，P=0．004）及血清乳酸脱氢酶升高（HR=0．552，P：0．013）是影响肺癌合并中重度低钠血症患者生存时间的危险因素。结论肺癌合并重度低钠血症的患者中位生存时间短。在肺癌合并中重度低钠血症的患者中，ECOG评分≥2分及血清乳酸脱氢酶升高也是患者生存时间缩短的不良预后因素。OBJECTIVE Hyponatremia is one of the common electrolyte abnormalities in lung cancer patients,it may be an indicator of poor prognosis. The purpose of this study is to explore the prognostic role of the hyponatremia and others prognostic factors of lung cancer associated moderate and severe hyponatremia. METHODS Ninty-four patients with lung cancer and serum sodium less than 130 mmol/L were enrolled in this study,which were collected from 1st Aug. 2010 to 1st Mar. 2015. We collected the clinical data of these patients and classified patients into two groups： moderate hyponatremia （sodium 125--129 mmol/L）and severe hyponatremia （sodium〈125 mmol/L）. Analysis was performed to identify the difference of the survival time and the factors affecting survival time. RESULTS A difference in the median survival time was observed between moderate hyponatremia and severe hyponatremia（123 d vs 48 d,P： 0.09）. In the uni- variate analysis,the elevation of lactate dehydrogenase （43 d vs 170 d,P〈0. 001）, ECOG≥2 （48 d vs 240 d,P%0. 001） and diagnosis with malignant pleural effusion （60 d vs 150 d,P=0. 012） were associated with poor prognosis. In multiva- riate analysis, the serum sodium level （ HR = 1.759, P = 0.021 ）, performance status （ ECOG≥2, HR = 0. 443, P = 0. 004） and elevation of lactate dehydrogenase （HR= 0. 552, P= 0. 013） were indicators of poor prognosis. CONCLUSIONS Lung cancer patients with severe hyponatremia have the shortest survival time. The performance status （ECOG≥2）and elevation of lactate dehydrogenase are also significant factors of poor prognosis in the these patients.

关 键 词：肺肿瘤 低钠血症 生存时间 预后 

分 类 号：R734.2[医药卫生—肿瘤]