摘要
目的分析血清甲状腺激素、中性粒细胞淋巴细胞比值(NLR)及C反应蛋白/白蛋白比值(CRP/ALB)与肺癌术后谵妄的关系。方法选取2021年1月至2022年12月于北京市第六医院进行肺癌根治术患者118例作为研究对象。根据ICU意识混乱评分法进行谵妄评估,有35例患者发生术后谵妄(谵妄组),83例患者术后未发生谵妄(非谵妄组)。分析影响肺癌患者术后谵妄的单因素,采用多元Logistic回归分析影响肺癌术后谵妄的多因素;比较谵妄组不同谵妄程度患者血清甲状腺激素、CRP/ALB、NLR水平;采用Pearson相关系数分析血清甲状腺激素、CRP/ALB、NLR与肺癌术后谵妄的相关性。结果两组性别、合并患有高血压、ASA分级以及T_4、TSH、FT_4水平等指标比较,差异无统计学意义(P>0.05);两组年龄、合并患有糖尿病、睡眠障碍以及T_(3)、FT_(3)、CRP/ALB、NLR水平比较,差异有统计学意义(P<0.05);经多元Logistic回归分析显示:年龄≥60岁、合并患有糖尿病、睡眠障碍以及T_(3)<1.31 nmol/L、FT_(3)<5.15 pmol/L、CRP/ALB>0.120、NLR≥7.79均是影响肺癌发生术后谵妄的危险因素(P<0.05);轻度、重度术后谵妄患者T_4、TSH、FT_4水平比较,差异无统计学意义(P>0.05);轻度术后谵妄患者T_(3)、FT_(3)水平高于重度术后谵妄患者,CRP/ALB、NLR水平低于重度术后谵妄患者,差异均有统计学意义(P<0.05);Pearson相关性分析显示:T_(3)、FT_(3)与肺癌术后谵妄呈负相关,CRP/ALB、NLR与肺癌术后谵妄呈正相关(P<0.05)。结论肺癌根治术患者术后T_(3)、FT_(3)、CRP/ALB、NLR水平与术后谵妄发生有一定关联,通过检测上述指标水平可为临床评估术后谵妄严重程度提供参考资料。
Objective To analyze the relationship between serum thyroid hormone,neutrophil to lymphocyte ratio(NLR)and C-reactive protein/Albumin ratio(C-reactive protein/Albumin,CRP/ALB)and delirium after lung cancer surgery.Methods A total of 118 patients who underwent radical lung cancer surgery at Beijing Sixth Hospital from January 2021 to December 2022 were selected as study subjects.Delirium was assessed using the ICU Confusion Scale.Among the patients,35 developed postoperative delirium(delirium group),while 83 did not develop postoperative delirium(non-delirium group).The individual factors that influenced postoperative delirium in lung cancer were analyzed.Multivariate logistic regression analysis was used to analyze the multiple factors that contributed to delirium after lung cancer surgery.Furthermore,serum thyroid hormone,CRP/ALB,and NLR levels in patients with different degrees of delirium in the delirium group were compared.Pierce correlation coefficient was used to analyze the correlation of serum thyroid hormone,CRP/ALB,NLR and delirium after lung cancer surgery.Results There were no significant differences between the two groups in terms of sex,hypertension,ASA grade,T4,TSH,FT4 levels and other indicators(P>0.05).However,there were statistically significant differences in age,diabetes,sleep disturbance,and T3,FT3,CRP/ALB,and NLR levels between the two groups(P<0.05).Multivariate logistic regression analysis showed that age≥60 years old,combined with diabetes,sleep disorders and T3<1.31 nmol/L,FT3<5.15 pmol/L,CRP/ALB>0.120,and NLR≥7.79 were all risk factors for postoperative delirium in lung cancer(P<0.05).When comparing the T4,TSH,and FT4 levels in patients with mild and severe postoperative delirium,there was no statistically significant(P>0.05).However,the levels of T3 and FT3 in patients with mild postoperative delirium were higher than those in patients with severe postoperative delirium,and the levels of CRP/ALB and NLR were lower than those in patients with severe postoperative delirium.These differences were statistically significant(P<0.05).According to Pearson correlation analysis,T3 and FT3 were negatively correlated with postoperative delirium in lung cancer,and CRP/ALB and NLR were positively correlated with postoperative delirium in lung cancer(P<0.05).Conclusion There is a correlation between postoperative T3,FT3,CRP/ALB,and NLR levels in lung cancer patients undergoing radical surgery and the occurrence of postoperative delirium.Detecting the levels of these indicators can provide reference data for clinically evaluating the severity of postoperative delirium.
作者
尚明煦
魏丽娟
是若春
SHANG Mingxu;WEI Lijuan;SHI Ruochun(Department of Critical Care Medicine,Beijing Sixth Hospital,Beijing,China,100007;Respiratory Department of Beijing Sixth Hospital,Beijing,China,100007)
出处
《分子诊断与治疗杂志》
2024年第1期174-177,182,共5页
Journal of Molecular Diagnostics and Therapy
基金
北京市科技计划课题项目(Z2211000029033)。
