肺癌合并脑出血的影响因素及其诊断价值

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摘要目的探讨肺癌合并脑出血（LCRCH）的影响因素及主要因素的诊断价值。方法回顾性分析2014年3月至2020年4月在达州市中心医院住院治疗的307例肺癌患者的临床资料，其中56例LCRCH患者为试验组，251例肺癌患者为对照组。采用单因素分析和倾向性评分匹配法（PSM）筛选出可疑的影响因素，采用logistic回归分析其独立危险因素，绘制受试者工作特征（ROC）曲线并计算各项诊断指标。结果单因素分析和PSM后结果显示，试验组和对照组的血小板（PLT）、凝血酶原时间（PT）以及血清肿瘤标志物癌胚抗原（CEA）、糖类抗原（CA）125、CA199比较，差异有统计学意义（P<0.05）；两组的性别、年龄、肺癌类型、活化部分凝血活酶时间（APTT）、国际标准化比值（INR）以及血清肿瘤标志物神经元特异性烯醇化酶（NSE）、细胞角质蛋白19片段抗原21-1（CYFRA21-1）比较，差异无统计学意义（P>0.05）。logistic回归分析显示，CEA水平升高（β=0.001，OR=1.001，95%CI=1.000~1.002）、CA199水平升高（β=0.004，OR=1.004，95%CI=1.003~1.004）和PT延长（β=0.157，OR=1.170，95%CI=1.084~1.263）是LCRCH的独立危险因素（P<0.05）。PT对LCRCH诊断的ROC曲线下面积（AUC）为0.82（95%CI=0.74~0.89）。结论 PT延长、CEA和CA199水平升高是LCRCH的独立危险因素，其中PT可作为辅助诊断此疾病的良好指标。

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	万绍恒
	李中燕
	焦鑫
	王家驷

关键词 ：肺肿瘤, 脑出血, 凝血酶原时间, 糖类抗原199

Abstract：Objective To study the influencing factors of lung cancer related cerebral hemorrhage (LCRCH) and the diagnostic value of the main factors. Methods Clinical data of 307 patients with lung cancer hospitalized in Dazhou Central Hospital from March 2014 to April 2020 were retrospectively analyzed, including 56 patients with LCRCH in the experimental group and 251 patients with lung cancer in the control group. Single factor analysis and propensity score matching (PSM) were used to screen out the suspected influencing factors. Logistic regression was used to analyze the independent risk factors. Receiver operating characteristic (ROC) curve was drawn and the diagnostic indexes were calculated. Results The results of univariate analysis and PSM showed that platelets (PLT), prothrombin time (PT) and serum tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 125 and CA199 were significantly different between the test group and control group (P<0.05). There were no statistically significant differences in gender, age, lung cancer type, activated partial thrombin time (APTT), international standardized ratio (INR), and serum tumor marker neuron specific enolase (NSE), cyto-keratin 19 fragment antigen 21-1 (CyFRA21-1) between the two groups (P>0.05). Logistic regression analysis showed that CEA level was increased (β=0.001, OR=1.001, 95%CI=1.000-1.002), CA199 level was increased (β=0.004, OR=1.004, 95%CI=1.003-1.004) and PT was prolonged (β=0.157, OR=1.170, 95%CI=1.084-1.263) were independent risk factors for LCRCH (P<0.05). The area under ROC curve (AUC) of PT for LCRCH diagnosis was 0.82 (95%CI=0.74-0.89). Conclusion Prolonged PT and elevated CEA and CA199 levels are independent risk factors for LCRCH, and PT can be used as a good indicator for the diagnosis of this disease.

Key words： Lung tumor Cerebral hemorrhage Prothrombin time Carbohydrate antigen 199

作者简介: 万绍恒（1985-），男，江西南昌人，硕士，主要从事临床免疫学研究。

引用本文:

万绍恒；李中燕；焦鑫；王家驷. 肺癌合并脑出血的影响因素及其诊断价值[J]. 中国当代医药, 2022, 29(20): 166-169.
WAN Shaoheng； LI Zhongyan； JIAO Xin； WANG Jiasi. Influencing factors and diagnostic value of lung cancer related cerebral hemorrhage. 中国当代医药, 2022, 29(20): 166-169.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2022/V29/I20/166

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