老年消化道恶性肿瘤并发急性肺血栓栓塞患者预后相关危险因素分析
Prognosis and risk factors in elderly patients with malignant digestive system tumors with acute pulmonary thromboembolism

刘君君.老年消化道恶性肿瘤并发急性肺血栓栓塞患者预后相关危险因素分析[J].内科急危重症杂志,2019,25(3):192-194

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DOI：10.11768/nkjwzzzz20190305

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作者	单位	E-mail
刘君君	北京医院	song_kui@hotmail.com

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中文摘要:

目的: 分析消化道恶性肿瘤并发急性肺血栓栓塞（APTE）老年患者的临床特点和影响预后的危险因素。方法: 回顾性选择40例老年（≥60岁）消化道恶性肿瘤并发APTE患者为APTE组，选择年龄、性别和病种类似、同期入院的未并发APTE的43例患者为对照组，比较2组基线和随访的临床资料，Kaplan-Meier生存分析比较2组的中位生存时间和肿瘤无进展生存时间，分析影响预后的危险因素。结果:83例老年患者中，平均年龄（77.2±10.9）岁。2组间的基线D-二聚体水平有显著性差异 (P<0.05)；随访中65例（78.3%）患者死亡，2组间死亡率有显著性差异（92.5% vs 65.1%，P<0.05）。Kaplan-Meier生存分析显示2组的中位生存时间有显著性差异（5.4个月 vs 7.8个月，P<0.05），但肿瘤无进展生存时间无显著性差异（4.9个月 vs 5.6个月，P>0.05）。Cox回归分析显示高龄、低白蛋白、合并APTE和肿瘤远处转移是影响中位生存时间的危险因素（均P<0.05）。结论: 老年消化道恶性肿瘤并发APTE的患者临床表现不典型，死亡率高，高龄、低白蛋白、合并APTE和肿瘤远处转移是影响预后的危险因素。

英文摘要:

Objective: To evaluate the prognosis and risk factors in elderly patients with malignant digestive system tumors with acute pulmonary thromboembolism (APTE). Methods: We analyzed data from 83 elderly patients (≥60 years) with malignant digestive system tumors. Forty elderly patients who had malignant digestive system tumors and APTE served as APTE group, and 43 elderly patients without APTE served as the control group. The basic and follow-up clinical data were analyzed. Kaplan-Meier survival analysis was used to assess the median survival time and progression free time, and to evaluate the risk factor. Results: Eighty-three elderly patients with a mean age of 77.2±10.9 years were enrolled. There was significant difference in the D-dimer level between the two groups (P<0.05). Sixty-five patients died during the follow-up period, and there was significant difference in all-cause mortality between groups (90.0% vs 67.4%, P<0.05). Kaplan-Meier survival analysis showed significant difference in median survival time between two groups (P<0.05). However, there was no significant difference in tumor progression free time between the two groups (P<0.05). Cox regression analysis revealed that advanced age, low albumin level, APTE and metastasis were risk factors for prognosis (all P<0.05). Conclusions: Elderly patients with malignant digestive system tumors and APTE often have no typical presentations, and have poor prognosis. Therefore, preventive measures and care should be taken, especially in high-risk APTE patients.