预后营养指数及胸膜厚度与上皮型恶性胸膜间皮瘤患者生存时间的相关性研究  

Correlation between prognostic nutritional index and pleural thickness with survival time of epithelial malignant pleural mesothelioma patients

作　　者：周建宏 张艳丽 李立峰 卢沛令 Zhou Jianhong;Zhang Yanli;Li Lifeng;Lu Peiling(Department of Cardiothoracic Surgery,Chuxiong Yi Autonomous Prefecture People's Hospital,Yunnan Province,Chuxiong 675000,China;Anesthesia Department 1,Chuxiong Yi Autonomous Prefecture People's Hospital,Yunnan Province,Chuxiong 675000,China)

机构地区：[1]云南省楚雄彝族自治州人民医院胸心外科,楚雄675000 [2]云南省楚雄彝族自治州人民医院麻醉一科,楚雄675000

出　　处：《中华劳动卫生职业病杂志》2024年第2期118-123,共6页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的探讨预后营养指数(PNI)及胸膜厚度在上皮型恶性胸膜间皮瘤(MPM)患者预后评价中的作用。方法于2022年4月,回顾性分析2018年1月至2021年5月楚雄彝族自治州人民医院胸心外科收治的41例上皮型恶性胸膜间皮瘤患者资料及实验室数据,利用单因素及多因素分析评价患者总生存时间、临床特征等与PNI及胸膜厚度的关系。结果 41例患者以男性为主(26例,63.4%),中位年龄55岁,临床表现主要为胸痛(53.7%)、血性胸腔积液(75.6%)和胸痛合并血性胸腔积液(36.6%)。不同TNM分期、化疗4周期后疗效、PNI、化疗后最大胸膜厚度(post max)、化疗后3区post max和(post sum)患者中位生存时间存在差异(χ2=3.89、14.51、15.33、4.33、12.05,P<0.05)。与高PNI、post sum<32.26 mm患者比较,低PNI、post sum≥32.26 mm的MPM患者死亡风险更高,差异均有统计学意义(HR=1.52,95%CI:1.75~11.93,P=0.002;HR=1.70,95%CI:1.84~16.23,P=0.002)。结论化疗前PNI和post sum可作为预测上皮型MPM患者预后的评价指标。Objective To explore the role of prognostic nutritional index(PNI)and pleural thickness in the prognostic evaluation of patients with epithelial malignant pleural mesothelioma(MPM).Methods In April 2022,a retrospective analysis was conducted on the data and laboratory data of 41 patients with epithelial MPM admitted to the cardiothoracic surgery department of Chuxiong Yi Autonomous Prefecture People's Hospital from January 2018 to May 2021.Univariate and multivariate analysis were used to evaluate the relationships between total survival time,clinical characteristics,PNI and pleural thickness in patients.Results The 41 patients were mostly male(26 cases,63.4%),with a median age of 55 years old.The main clinical manifestations were chest pain(53.7%),bloody pleural effusion(75.6%),and chest pain combined with bloody pleural effusion(36.6%).The median survival time of patients with different TNM stage,efficacy after 4 cycles of chemotherapy,PNI,maximum pleural thickness after chemotherapy(post max),sum of post max in 3 zones after chemotherapy(post sum)were statistically different(χ2=3.89,14.51,15.33,4.33,12.05,P<0.05).Compared with patients with high PNI and post sum<32.26 mm,MPM patients with low PNI and post sum≥32.26 mm have higher risk of death,and the differences were statistically significant(HR=1.52,95%CI:1.75-11.93,P=0.002;HR=1.70,95%CI:1.84-16.23,P=0.002).Conclusion PNI and post sum can be used to predict the prognosis of patients with epithelial MPM.

关 键 词：间皮瘤 上皮 恶性 胸膜 预后营养指数 胸膜厚度 预后 

分 类 号：R734.3[医药卫生—肿瘤]