• 成都市第七人民医院呼吸科(成都,610021);
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【摘要】 目的  研究肺癌患者的气道高反应性和肺通气功能情况,并探讨其易感因素,为肺癌患者肺通气功能的临床评估提供依据。 方法  对2010年4月-2011年4月收治的40例肺癌患者(A组)进行术前肺功能检测及气管激发试验,选取同期的健康体检者40例做对照组(B组),并采用logistic逐步回归分析肺癌患者的气道高反应性的易感因素。 结果  ①A组患者的用力肺活量、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、最高呼气流量(peak expiratory flow,PEF)以及最大呼气中期流量均小于B组,且差异有统计学意义(P=0.000);②A组的FEV1估计异常人数和PEF估计异常人数均多于B组(P lt;0.05);③A组组胺气道激发试验阳性者多于B组(χ2=5.000,P=0.025),且A组PD20FEV1低于对照组[分别为(4.69±0.82)、(8.32±1.43)μmol/L;t=13.930,P=0.000];④logistic逐步回归分析表明影响A组患者的气道高反应性的因素为年龄、分型、TNM分期、病史、吸烟。 结论  肺癌气道反应性增高,且肺功能下降,由于肺癌气道高反应性的易感因素较多,因此需对合并因素较多者进行及时的预防,防止由于气道阻力增加和气道狭窄引起的胸闷、咳嗽、喘息和呼吸困难等症状。
【Abstract】 Objective  To learn the condition of bronchial hyper-reactivity and pulmonary function in patients with lung cancer, and explore the risk factors for bronchial hyper-reactivity in order to provide clinical reference for pulmonary function evaluation in patients with lung cancer. Methods  Forty patients with lung cancer treated in our hospital from April 2010 to April 2011 (research group) took pulmonary function and tracheal stimulation tests before operation, and in the meanwhile, 40 healthy people were chosen as controls. The logistic regression analysis was employed to analyze the risk factors for bronchial hyper-reactivity. Results  The forced vital capacity, forced expiratory volume in one second (FEVl), peak expiratory flow (PEF) and maximal mid expiratory flow in the research group patients were all significantly lower than those in the control group patients (P=0.000). The number of patients with estimated FEVl and PEF abnormality in the research group was more than that in the control group (P=0.05). The number of patients positive in histamine bronchial provocation test in the research group was more than that in the control group (χ2=5.000, P=0.025), and the PD20FEV1 level of the research group was lower than that of the control group [(4.69±0.82) and (8.32±1.43) μmol/L; t=13.930, P=0.000]. Logistic regression analysis showed that the risk factors for bronchial hyper-reactivity in patients with lung cancer were age, type, TNM stage, history of lung cancer, and smoking. Conclusions  The airway reactivity elevates and the lung cancer pulmonary function decreases in lung cancer patients. Because there are many risk factors, prevention should be taken for patients with combined risk factors to avoid the occurrence of chest distress, cough, gasp and dyspnea caused by increased airway resistance and stricture.

引用本文: 柯华. 肺癌患者气道高反应性的分析. 华西医学, 2011, 26(12): 1825-1827. doi: 复制