冠心病合并肺癌患者同期手术临床效果及预后相关影响因素分析  

Analysis of Clinical Effect and Prognostic Factors of Simultaneous Operation in Patients with Coronary Heart Disease and Lung Cancer

作　　者：董颖[1] DONG Ying(The Second Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学第二附属医院,450000

出　　处：《实用癌症杂志》2023年第4期604-607,共4页The Practical Journal of Cancer

摘　　要：目的 探讨冠心病合并肺癌患者同期手术临床效果及预后相关影响因素。方法 选择手术治疗的冠心病合并肺癌患者116例,按照患者术后随访结果分成预后不良组、预后良好组。经自制调查问卷了解患者临床资料,先经单因素分析,将有差异的项目纳入多因素Logistic回归系统,分析预后相关影响因素。结果 116例冠心病合并肺癌患者中预后良好95例(81.90%),预后不良21例(18.10%);多因素分析显示,年龄≥60岁、心功能NYHA分级Ⅲ~Ⅳ级、血清肌酸激酶MB型同工酶(CK-MB)水平>24 U/L、癌胚抗原(CEA)阳性、CD4^(+)值<35%、CD8^(+)值>30%、第1秒用力呼气量(FEV1)/用力肺活量(FVC)值<0.7是影响冠心病合并肺癌患者同期外科手术预后的独立危险因素(P<0.05)。结论 同期外科手术在治疗冠心病合并肺癌方面效果确切,预后相对较好。年龄、心脏功能、CK-MB水平、CEA水平、免疫功能与肺功能是造成预后不良的危险因素,临床需据此针对性制定干预措施,以改善预后。Objective To explore the clinical effect and prognostic factors of simultaneous surgery in patients with coronary heart disease and lung cancer.Methods 116 patients with coronary heart disease and lung cancer who underwent simultaneous surgery were selected.According to the follow-up results,the patients were divided into poor prognosis group and good prognosis group.Through self-made questionnaire to understand the clinical data of the patients,the items with differences were included in the multivariate logistic regression system through univariate analysis to analyze the relevant prognostic factors.Results Among 116 patients with coronary heart disease and lung cancer,95(81.90%)had good prognosis and 21(18.10%)had poor prognosis;Multivariate analysis showed that age≥60 years old,NYHA gradeⅢ~Ⅳof cardiac function,serum creatine kinase MB isozyme(CK-MB)level>24 U/L,carcinoembryonic antigen(CEA)positive,CD4+value<35%,CD8+value>30%,forced expiratory volume(FEV1)/forced vital capacity(FVC)value<0.7 were independent risk factors affecting the prognosis of patients with coronary heart disease and lung cancer in the same period(P<0.05).Conclusion Simultaneous surgical operation is effective in the treatment of coronary heart disease with lung cancer and has a good correlation with prognosis.Age,cardiac function,CK-MB level,CEA level,immune function and lung function are the risk factors for poor prognosis.Therefore,it is necessary to formulate targeted intervention measures to improve the prognosis.

关 键 词：冠心病 肺癌 同期手术效果 预后 影响因素 

分 类 号：R734.2[医药卫生—肿瘤]