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目的低钠血症是肺癌最常见的电解质紊乱之一,可能是其不良预后因素。本研究旨在探讨不同血钠水平对于肺癌预后的影响及其他可能影响肺癌合并中重度低钠血症的患者生存的预后因素。方法以北京医院2010-08-01-2015-03-01收治的经病理确诊的94例肺癌合并中重度低钠血症患者作为研究对象,收集临床资料。将其分为中度低钠血症组(血钠125~129mmol/L)66例和重度低钠血症组(血钠<125mmol/L)28例,分析患者生存时间的差异及影响生存的预后因素。结果重度低钠血症较中度低钠血症患者的中位生存时间缩短(123dvs 48d,P=0.09)。单因素分析中影响患者生存时间的因素包括血清乳酸脱氢酶升高(中位生存时间43dvs 170d,P<0.001)、美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)评分≥2分(中位生存时间48dvs 240d,P<0.001),以及合并有恶性胸腔积液(中位生存时间60dvs 150d,P=0.012)。多因素分析中血钠水平(HR=1.759,P=0.021)、ECOG评分(HR=0.443,P=0.004)及血清乳酸脱氢酶升高(HR=0.552,P=0.013)是影响肺癌合并中重度低钠血症患者生存时间的危险因素。结论肺癌合并重度低钠血症的患者中位生存时间短。在肺癌合并中重度低钠血症的患者中,ECOG评分≥2分及血清乳酸脱氢酶升高也是患者生存时间缩短的不良预后因素。
Purpose Hyponatremia is one of the most common electrolyte disturbances in lung cancer and may be its adverse prognostic factor. This study aimed to investigate the effects of different serum sodium levels on the prognosis of lung cancer and other prognostic factors that may affect the survival of patients with lung cancer complicated with moderate and severe hyponatremia. Methods Ninety-four patients with moderate-to-severe hyponatremia who were diagnosed by pathology in Beijing Hospital from August 2010 to January 2015 were enrolled in this study. Clinical data were collected. They were divided into moderate hyponatremia group (serum sodium 125 ~ 129mmol / L) 66 cases and severe hyponatremia group (serum sodium <125mmol / L) in 28 cases, analysis of patients with differences in survival time and affect survival Prognostic factors. Results The median survival time of patients with severe hyponatremia was shorter than that of moderate hyponatremia (123d vs 48d, P = 0.09). Factors influencing the survival time of patients in univariate analysis included elevated serum lactate dehydrogenase (median survival 43 days vs 170 days, P <0.001), Eastern Cooperative Oncology Group (ECOG) score ≥2 points (median The median survival time was 48d vs 240d (P <0.001), and malignant pleural effusion (median survival time 60d vs 150d, P = 0.012). In the multivariate analysis, serum sodium level (HR = 1.759, P = 0.021), ECOG score (HR = 0.443, P = 0.004) and serum lactate dehydrogenase (HR = 0.552, P = 0.013) Risk factors for survival of patients with severe hyponatremia. Conclusions The median survival time of lung cancer patients with severe hyponatremia is short. In patients with moderate and severe hyponatremia with lung cancer, an ECOG score of 2 or higher and elevated serum lactate dehydrogenase are also poor prognostic factors in patients with shortened survival.