慢性阻塞性肺疾病与慢性阻塞性肺疾病并肺癌患者的临床特征
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摘要
目的比较慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)、COPD并肺癌患者的临床特征。方法回顾性分析107例COPD患者(COPD组),43例COPD并肺癌患者(合并组)的临床资料。结果 COPD组合并高血压、糖尿病、冠心病比率,吸烟指数及白细胞计数、红细胞沉降率、降钙素原、C反应蛋白水平与合并组比较差异无统计学意义(P>0.05);COPD组第1秒用力呼气容积(forced expiratory volume in one second, FEV_1)[(1.87±0.83)L]、用力肺活量(forced vital capacity, FVC)[(2.98±0.92)L]、FEV_1/FVC[(61.94±8.17)%]、FEV_1占预计值百分比(FEV_1%pred)[(68.13±20.97)%]高于合并组[(1.56±0.69)L、(2.63±1.04)L、(58.72±7.87)%、(60.70±20.80)%],血浆D-二聚体[(0.56±0.39)mg/L]水平低于合并组[(1.85±0.15)mg/L](P<0.05);COPD组GOLD肺功能重度+极重度比率(36.45%)低于合并组(62.79%)(P<0.05)。结论 COPD并肺癌患者肺功能较COPD患者差,血液黏稠度高,易发生血栓栓塞性疾病。
Objective To compare the clinical characteristics of patients with chronic obstructive pulmonary disease(COPD) versus COPD complicated with lung cancer. Methods The clinical data of 107 COPD patients(COPD group) and 43 patients with COPD and lung cancer(combined group) were retrospectively analyzed. Results There was no significant difference in the rates of complications as hypertension, diabetes mellitus and coronary heart disease, smoking index, white blood cell count, erythrocyte sedimentation rate, procalcitonin and C-reactive protein between two groups(P>0.05). The forced expiratory volume in one second(FEV_1)((1.87±0.83) L), forced vital capacity(FVC)((2.98±0.92) L), FEV_1/FVC((61.94±8.17)%) and FEV_1%pred((68.13±20.97)%) in COPD group were significantly higher than those in combined group((1.56±0.69) L,(2.63±1.04) L,(58.72±7.87)%,(60.70±20.80)%), and plasma D-Dimer((0.56±0.39) mg/L) was significantly lower than that in combined group((1.85±0.15) mg/L)(P<0.05). The ratio of GOLD severity + extreme severity was significantly lower in COPD group(36.45%) than that in combined group(62.79%)(P<0.05). Conclusion COPD complicated with lung cancer results in poorer prognosis, higher blood viscosity and higher risk for thrombosis than COPD.
Objective To compare the clinical characteristics of patients with chronic obstructive pulmonary disease(COPD) versus COPD complicated with lung cancer. Methods The clinical data of 107 COPD patients(COPD group) and 43 patients with COPD and lung cancer(combined group) were retrospectively analyzed. Results There was no significant difference in the rates of complications as hypertension, diabetes mellitus and coronary heart disease, smoking index, white blood cell count, erythrocyte sedimentation rate, procalcitonin and C-reactive protein between two groups(P>0.05). The forced expiratory volume in one second(FEV_1)((1.87±0.83) L), forced vital capacity(FVC)((2.98±0.92) L), FEV_1/FVC((61.94±8.17)%) and FEV_1%pred((68.13±20.97)%) in COPD group were significantly higher than those in combined group((1.56±0.69) L,(2.63±1.04) L,(58.72±7.87)%,(60.70±20.80)%), and plasma D-Dimer((0.56±0.39) mg/L) was significantly lower than that in combined group((1.85±0.15) mg/L)(P<0.05). The ratio of GOLD severity + extreme severity was significantly lower in COPD group(36.45%) than that in combined group(62.79%)(P<0.05). Conclusion COPD complicated with lung cancer results in poorer prognosis, higher blood viscosity and higher risk for thrombosis than COPD.
引文
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[2] 骆树新,许西琳,关键.吸烟与慢性阻塞性肺疾病肺功能相关性研究[J].中华实用诊断与治疗杂志,2011,25(6):621-622.
[3] VESTBO J, HURD S S, AGUSTI A G, et al. Global strategy for the diagnosis management and prevention of chronic obstructive pulmonary disease: GOLD executive summary[J]. Am J Respir Crit Care Med,2013,187(4):347-365.
[4] 中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.慢性阻塞性肺疾病基层诊疗指南[J].中华全科医师杂志,2018,17(11):856-870.
[5] 支修益,石远凯,于金明.中国原发性肺癌诊疗规范(2015版)[J].中华肿瘤杂志,2015,37(1):67-78.
[6] 陈亚红.2017年GOLD 慢性阻塞性肺疾病诊断、治疗及预防的全球策略解读[J].中国医学前沿杂志(电子版),2017,9(1):37-47.
[7] 赵松林,聂秀红,张霖,等.慢性阻塞性肺疾病合并原发性支气管肺癌118例临床特征分析[J].中国肺癌杂志,2017,20(8):538-542.
[8] 姬利萍,邝先奎,杨佳,等.晚期肺癌患者凝血及纤溶异常与血栓形成的相关性[J].中华实用诊断与治疗杂志,2014,28(12):1203-1207.
[9] 陈渝宁,孟冬娅,方秀菊.D-二聚体定量检测在肺部疾病的意义[J].中华实用诊断与治疗杂志,2008,22(1):4-5.