肺癌患者气道高反应性的分析

【】　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（forcedexpiratoryvolumeinonesecond，FEV1）、最高呼气流量（peakexpiratoryflow，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<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　Tolearntheconditionofbronchialhyper-reactivityandpulmonaryfunctioninpatientswithlungcancer,andexploretheriskfactorsforbronchialhyper-reactivityinordertoprovideclinicalreferenceforpulmonaryfunctionevaluationinpatientswithlungcancer.　Methods　FortypatientswithlungcancertreatedinourhospitalfromApril2010toApril2011(researchgroup)tookpulmonaryfunctionandtrachealstimulationtestsbeforeoperation,andinthemeanwhile,40healthypeoplewerechosenascontrols.Thelogisticregressionanalysiswasemployedtoanalyzetheriskfactorsforbronchialhyper-reactivity.　Results　Theforcedvitalcapacity,forcedexpiratoryvolumeinonesecond(FEVl),peakexpiratoryflow(PEF)andmaximalmidexpiratoryflowintheresearchgrouppatientswereallsignificantlylowerthanthoseinthecontrolgrouppatients(P=0.000).ThenumberofpatientswithestimatedFEVlandPEFabnormalityintheresearchgroupwasmorethanthatinthecontrolgroup(P=0.05).Thenumberofpatientspositiveinhistaminebronchialprovocationtestintheresearchgroupwasmorethanthatinthecontrolgroup(χ2=5.000,P=0.025),andthePD20FEV1leveloftheresearchgroupwaslowerthanthatofthecontrolgroup(4.69±0.82)and(8.32±1.43)μmol/L;t=13.930,P=0.000.Logisticregressionanalysisshowedthattheriskfactorsforbronchialhyper-reactivityinpatientswithlungcancerwereage,type,TNMstage,historyoflungcancer,andsmoking.　Conclusions　Theairwayreactivityelevatesandthelungcancerpulmonaryfunctiondecreasesinlungcancerpatients.Becausetherearemanyriskfactors,preventionshouldbetakenforpatientswithcombinedriskfactorstoavoidtheoccurrenceofchestdistress,cough,gaspanddyspneacausedbyincreasedairwayresistanceandstricture.