摘要
目的探讨电解质紊乱和酸碱失衡与非小细胞肺癌患者预后的关系。方法选取2012年1月—2013年9月海南省中医院收治的非小细胞肺癌患者62例作为观察组,选取同期在海南省中医院体检健康者30例作为对照组。比较对照组与观察组、不同预后患者血电解质和酸碱失衡情况,并分析电解质紊乱和酸碱失衡与非小细胞肺癌患者预后的相关性及其对非小细胞肺癌患者预后的预测价值。结果治疗前观察组患者血清Ca^(2+)水平、单纯酸碱失衡发生率、二重酸碱失衡发生率、三重酸碱失衡发生率高于对照组,血清K^+、Cl^-、Na^+水平低于对照组(P<0.05)。随访期间观察组患者存活39例(存活组),死亡23例(死亡组);治疗前后存活组患者血清Ca^(2+)水平、单纯酸碱失衡发生率、二重酸碱失衡发生率、三重酸碱失衡发生率低于死亡组,血清K^+、Cl^-、Na^+水平高于死亡组(P<0.05)。Spearman秩相关性分析结果显示,血清Ca^(2+)水平和酸碱失衡与非小细胞肺癌患者预后呈负相关(r_s值分别为-0.818、-0.876,P<0.05);血清K^+、Cl^-、Na^+水平与非小细胞肺癌患者预后呈正相关(r_s值分别为0.824、0.831、0.852,P<0.05)。血清Ca^(2+)水平预测非小细胞肺癌患者预后的曲线下面积(AUC)为0.842[95%CI(0.765,0.926)],当其为3.76 mmol/L时灵敏度为84.62%,特异度为82.61%,准确度为83.87%;血清K^+水平预测非小细胞肺癌患者预后的AUC为0.815[95%CI(0.721,0.938)],当其为2.71 mmol/L时灵敏度为82.05%,特异度为73.91%,准确度为79.03%;血清Cl^-水平预测非小细胞肺癌患者预后的AUC为0.805[95%CI(0.703,0.911)],当其为73.62mmol/L时灵敏度为79.49%,特异度为69.57%,准确度为75.81%;血清Na^+水平预测非小细胞肺癌患者预后的AUC为0.872[95%CI(0.772,0.968)],当其为120.55 mmol/L时灵敏度为87.18%,特异度为78.26%,准确度为83.87%。酸碱失衡预测非小细胞肺癌患者预后的灵敏度为73.91%,特异度为79.49%,符合率为77.42%。结论电解质紊乱和酸碱失衡与非小细胞肺癌患者预后有关,对患者预后均具有一定的预测价值。
Objective To explore the relationship between electrolyte disturbance,acid-base imbalance and prognosis in patients with non-small cell lung cancer. Methods A total of 62 patients with non-small cell lung cancer were selected as observation group in Hainan Provincial Hospital of Traditional Chinese Medicine from January 2012 to September 2013,meanwhile 30 healthy people admitted to this hospital for physical examination were selected as control group. Serum electrolyte level and incidence of acid-base imbalance were compared between control group and observation group,in patients with different prognosis; correlations of electrolyte disturbance and acid-base imbalance with prognosis in patients with non-small cell lung cancer,and predictive value of electrolyte disturbance and acid-base imbalance on prognosis in patients with non-small cell lung cancer were analyzed. Results Before treatment, serum Ca^(2+) level, incidence of isolated acid-base imbalance,amphimorphic acid-base imbalance and tripartite acid-base imbalance of observation group were statistically significantly higher than those of control group,while serum levels of K^+ ,Cl^- and Na^+ of observation group were statistically significantly lower than those of control group(P < 0. 05). Of observation group,39 cases survived during the follow-up(served as survival group),23 cases died(served as death group); before and after treatment,serum Ca^(2+) level,incidence of isolated acid-base imbalance,amphimorphic acid-base imbalance and tripartite acid-base imbalance of survival group were statistically significantly lower than those of death group, while serum levels of K^+ ,Cl^- and Na^+ of survival group were statistically significantly higher than those of control group(P < 0. 05). Spearman rank correlation analysis results showed that,serum Ca^(2+) level(r_s=-0. 818) and acid-base imbalance(r_s=-0. 876) was negatively correlated with the prognosis in patients with non-small cell lung cancer,respectively(P < 0. 05); serum level of K^+ (r_s= 0. 824),of Cl^- (r_s= 0. 831),of Na^+ (r_s= 0. 852) was positively correlated with the prognosis in patients with non-small cell lung cancer,respectively(P< 0. 05). AUC of serum Ca^(2+) level in predicting the prognosis in patients with non-small cell lung cancer was 0. 842 [95% CI(0. 765,0. 926) ],when it was 3. 76 mmol/L,the sensitivity was 84. 62%,the specificity was 82. 61%,the accuracy rate was 83. 87%; AUC of serum K^+ level in predicting the prognosis in patients with non-small cell lung cancer was 0. 815 [95%CI(0. 721,0. 938) ],when it was 2. 71 mmol/L,the sensitivity was 82. 05%,the specificity was 73. 91%, the accuracy rate was 79. 03%; AUC of serum Cl^- level in predicting the prognosis in patients with non-small cell lung cancer was 0. 805[95% CI(0. 703,0. 911) ],when it was 73. 62 mmol/L,the sensitivity was 79. 49%,the specificity was 69. 57%,the accuracy rate was 75. 81%; AUC of serum Na^+ level in predicting the prognosis in patients with non-small cell lung cancer was 0. 872 [95% CI(0. 772,0. 968) ],when it was 120. 55 mmol/L,the sensitivity was 87. 18%,the specificity was 78. 26%,the accuracy rate was 83. 87%. The sensitivity of acid-base imbalance in predicting the prognosis in patients with non-small cell lung cancer was 73. 91%, the specificity was 79. 49%, the coincidence rate was 77. 42%. Conclusion Electrolyte disturbance and acid-base imbalance are correlated with the prognosis in patients with non-small cell lung cancer,have certain predictive value on the prognosis.
出处
《实用心脑肺血管病杂志》
2017年第5期48-52,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
癌
非小细胞肺
电解质
酸碱失衡
生存
Carcinoma,non-small-cell lung
Electrolytes
Acid-base imbalance
Survival
