血清尿酸对非小细胞肺癌患者围术期急性缺血性卒中的预测价值研究  

Predictive Value of Serum Uric Acid in Perioperative Acute Ischemic Stroke in Patients with Non-small Cell Lung

作　　者：白海威[1] 米小昆[1] 刘青蕊[1] 祝琳[1] 王英南[2] 刘俊艳[3] 韩颖[1] BAI Haiwei;MI Xiaokun;LIU Qingrui;ZHU Lin;WANG Yingnan;LIU Junyan;HAN Ying(Department of Neurology,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Department of Gastroenterology,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Department of Neurology,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第四医院神经内科,河北省石家庄市050011 [2]河北医科大学第四医院消化内科,河北省石家庄市050011 [3]河北医科大学第三医院神经内科,河北省石家庄市050051

出　　处：《中国全科医学》2023年第36期4545-4551,共7页Chinese General Practice

基　　金：河北省医学科学研究课题(20211242)。

摘　　要：背景围术期急性缺血性卒中(POAIS)是外科手术的严重并发症,可增加手术死亡率、降低患者生活质量,其发病机制复杂,尤其在非小细胞肺癌(NSCLC)患者中缺乏相关研究。目的探讨NSCLC患者发生POAIS的影响因素及血清尿酸(SUA)对NSCLC患者发生POAIS的预测价值。方法收集2014年7月—2022年4月在河北医科大学第四医院行肺部切除手术发生POAIS的25例NSCLC患者作为病例组,按年龄、性别进行匹配后随机选取126例未发生POAIS的NSCLC患者作为对照组。收集所有患者术前基线数据、术中数据及术后病理相关数据。通过多因素Logistic回归分析探究NSCLC患者发生POAIS的影响因素,采用受试者工作特征(ROC)曲线评价SUA对NSCLC患者发生POAIS的预测价值。结果151例患者平均年龄(64±7)岁,男性占57.62%(87/151)。多因素Logistic回归分析结果显示,SUA是NSCLC患者发生POAIS的影响因素[OR=0.990,95%CI(0.982,0.998),P=0.019]。ROC曲线结果显示,SUA预测NSCLC患者发生POAIS的ROC曲线下面积为0.64,最佳临界值为307.40μmol/L,灵敏度58.7%,特异度76.0%。结论SUA水平是NSCLC患者出现POAIS的独立预测因素。基线更高的SUA水平可能预示着更低的POAIS发生风险。Background Perioperative acute ischemic stroke(POAIS)is a severe complication of surgery,which can increase surgical mortality and reduce patients'quality of life.The pathogeneses are complex and rarely explored,especially in patients with non-small cell lung cancer(NSCLC).Objective To investigate the influencing factors of POAIS in NSCLC patients and the predictive value of serum uric acid(SUA)on the occurrence of POAIS in NSCLC patients.Methods A total of 25 NSCLC patients admitted to the Fourth Hospital of Hebei Medical University from July 2014 to April 2022,who suffered from POAIS following lung resection were selected as the case group,while 126 patients without POAIS were randomly selected as the control group after matching by age and gender.The preoperative baseline data,intraoperative data and postoperative pathology-related data of all patients were collected.Multivariate Logistic regression analysis was performed to explore the influencing factors of POAIS in the NSCLC patients,and the receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of preoperative SUA on the development of POAIS in NSCLC patients.Results The average age of the 151 patients was(64±7)years,57.62%(87/151)of whom were male.The multivariate Logistic regression analysis showed that SUA was an influencing factor of POAIS in NSCLC patients〔OR=0.990,95%CI(0.982,0.998),P=0.019〕.The ROC curve indicated that the area under the curve(AUC)of SUA to predict POAIS in NSCLC patients was 0.64,with an optimal threshold value of 307.40μmol/L,sensitivity and specificity of 58.7%and 76.0%,respectively.Conclusion Preoperative SUA level can serve as an independent predictor of POAIS incidence in NSCLC patients.Higher SUA levels at baseline may predict a lower risk of POAIS.

关 键 词：癌 非小细胞肺 缺血性卒中 尿酸 围手术期 影响因素分析 预测 

分 类 号：R730.26[医药卫生—肿瘤]