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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2024年01期

页码:

25-29

栏目:

论著

出版日期:

2024-02-20

文章信息/Info

Title:

Pathological types and clinical characteristics of IPF-LC patients in Xining

作者:

拉周措毛; 山春玲; 李国蓉; 华 毛

西宁 81000,青海大学附属医院呼吸与危重医学科

Author(s):

Lazhou Cuomao;  Shan Chunling;  Li Guorong;  Hua Mao.

Department of Respiratory Medicine, Affiliated Hospital of Qinghai University, Xining 810000, China

关键词:

青海西宁地区;  特发性肺纤维化;  支气管肺癌;  病理类型;  临床特征

Keywords:

Qinghai province;  Idiopathic pulmonary fibrosis;  Lung cancer;  Pathological type;  Clinical characteristics

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2024.01.005

摘要:

目的 分析特发性肺纤维化合并肺癌(idiopathic pulmonary fibrosis-lung cancer, IPF-LC)患者的病理类型及临床特征,IPF-LC的保护及危险因素。 方法 选择2014年11月至2022年10月我院收治的IPF患者190例,根据患者是否合并肺癌,分为单纯IPF组144例,IPF-LC组46例。收集两组临床资料、血气分析、影像学检查、血沉(erythrocyte sedimentation rate, ESR)、C反应蛋白(C reactive protein, CRP)水平。结果 单纯IPF组144例中,男95例(65.97%),女49例(34.03%),平均年龄(58.10±11.57)岁; IPF-LC组46例中,男41例(89.13%),女5例(10.87%),平均年龄(63.91±10.12)岁,两组性别和年龄比较差异具有统计学意义(P<0.05)。单纯IPF组平均吸烟指数250年支,IPF-LC组平均吸烟指数700年支,差异具有统计学意义(P<0.05); 单纯IPF组与IPF-LC组比较,咯血、胸痛、体重下降及杵状指差异有统计学意义(P<0.05); IPF-LC组中结节团块影分布上叶13例(28.26%)、下叶24例(52.17%)、外周37例(80.43%)。两组动脉血氧分压(alveolar oxygen partial pressure, PaO₂)、CRP、ESR水平具有统计学差异(P<0.05); PaO₂降低是IPF患者合并LC的危险因素(P<0.05)。结论 65岁以上吸烟指数高的男性IPF患者易合并LC; IPF-LC组较单纯IPF组易出现杵状指、咯血、胸痛、体重下降; IPF-LC组CRP、ESR水平高于单纯IPF组,提示慢性炎症介质在IPF-LC的发病过程中发挥作用。IPF-LC的影像学检查发现肿块常发生于纤维化明显区域,肺外周及下叶多见; PaO₂是IPF-LC的保护因素。

Abstract:

Objective To analyze the pathological types and clinical characteristics of idiopathic pulmonary fibrosis-lung cancer(IPF-LC)patients, the protection and risk factors of IPF-LC. Methods From November 2014 to October 2022, 190 IPF patients admitted to our hospital were divided into simple IPF group(n=144)and IPF-LC group(n=46)according to whether the patients were complicated with lung cancer. The clinical data, blood gas analysis, imaging examination, erythrocyte sedimentation rate(ESR)and C reactive protein(CRP)levels of the two groups were collected. Results Among the 144 cases in the simple IPF group, there were 95 males(65.97%)and 49 females(34.03), with an average age of(58.10±11.57)years; among the 46 cases in the IPF-LC group, there were 41 males(89.13%)and 5 females(10.87%), with an average age of(63.91±10.12)years, with a statistically significant difference in gender and age between the two groups(P<0.05). The average smoking index of the simple IPF group was 250 years, and the average smoking index of the IPF-LC group was 700 years, with a statistically significant difference(P<0.05); there were statistically significant differences in hemoptysis, chest pain, weight loss and clubbing between the simple IPF group and the IPF-LC group(P<0.05); in the IPF-LC group, there were 13 cases(28.26%)of nodular mass shadows in the upper lobe, 24 cases(52.17%)in the lower lobe, and 37 cases(80.43%)in the periphery. There were statistically significant differences in arterial oxygen partial pressure(PaO₂), CRP and ESR levels between the two groups(P<0.05); decreased PaO₂ was a risk factor for IPF patients with LC(P<0.05). Conclusion Male IPF patients over 65 years old with high smoking index are more likely to be complicated with LC; The IPF-LC group is more likely to have clubbing, hemoptysis, chest pain, and weight loss than the IPF group alone; the levels of CRP and ESR in the IPF-LC group are higher than those in the IPF group alone, suggesting that chronic inflammatory mediators play a role in the pathogenesis of IPF-LC; the imaging examination of IPF-LC shows that the masses often occur in the area of obvious fibrosis, peripheral lung and lower lobe; PaO₂ is a protective factor for IPF-LC.

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备注/Memo

备注/Memo:

基金项目: 青海省卫生健康委重点项目(2020-wjzd-04)
通信作者:拉周措毛, Email: 1490672417@qq.com

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更新日期/Last Update: 2024-02-20