Zhang Liang, Guan Lanjun, Tang Xiaoyue, Zhao Yong
Department of Endocrinology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China.
Department of Internal Medicine, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China.
Int J Gen Med. 2023 Oct 9;16:4573-4584. doi: 10.2147/IJGM.S433412. eCollection 2023.
Type 2 diabetes mellitus (T2DM) is associated with the occurrence of lung cancer. Postoperative lung cancer complications with acute respiratory distress syndrome (ARDS) are characterized by rapid onset and severe disease. This study aimed to analyze the effect of T2DM on the occurrence of ARDS in patients with lung cancer after surgery and its prognosis and further investigate the risk factors of postoperative complications of ARDS.
A total of 530 patients who developed lung cancer from December 2016 to December 2021 were retrospectively analyzed. The t- and chi-square tests were used to determine the relationship between whether the patients had combined diabetes and other clinical characteristics. Binary logistic and Cox risk regressions were used to analyze the independent risk factors for the development of ARDS in patients after surgery and the effect of each factor on the survival status of patients, respectively.
Fifty-three cases of ARDS occurred after lung cancer surgery, with an incidence of 10%. Binary logistic regression analysis demonstrated that the independent influencing factors that determined the occurrence of ARDS after surgery were the presence or absence of combined diabetes (odds ratio [OR] = 3.888, P<0.001), history of radiotherapy (OR = 2.039, P = 0.024), surgery mode (OR = 2.521, P = 0.002), and so on. Moreover, Cox risk regression analysis demonstrated that the presence or absence of combined diabetes (OR = 1.389, P = 0.039) and occurrence of ARDS (OR = 2.028, P = 0.037) were independent influencing factors on the patient survival time.
In lung cancer patients with T2DM, postoperative ARDS is more likely to occur, and both diabetes and postoperative ARDS are risk factors affecting the survival of patients with lung cancer. Preoperative and postoperative glycemic control and improved pulmonary ventilation should be enhanced to minimize the chance of ARDS.
2型糖尿病(T2DM)与肺癌的发生有关。肺癌术后并发急性呼吸窘迫综合征(ARDS)具有起病急、病情重的特点。本研究旨在分析T2DM对肺癌患者术后ARDS发生情况及其预后的影响,并进一步探讨ARDS术后并发症的危险因素。
回顾性分析2016年12月至2021年12月期间共530例肺癌患者。采用t检验和卡方检验确定患者是否合并糖尿病与其他临床特征之间的关系。分别采用二元逻辑回归和Cox风险回归分析术后患者发生ARDS的独立危险因素以及各因素对患者生存状况的影响。
肺癌手术后发生ARDS 53例,发生率为10%。二元逻辑回归分析显示,决定术后ARDS发生的独立影响因素包括是否合并糖尿病(比值比[OR]=3.888,P<0.001)、放疗史(OR=2.039,P=0.024)、手术方式(OR=2.521,P=0.002)等。此外,Cox风险回归分析显示,是否合并糖尿病(OR=1.389,P=0.039)和发生ARDS(OR=2.028,P=0.037)是影响患者生存时间的独立影响因素。
T2DM肺癌患者术后更易发生ARDS,糖尿病和术后ARDS均是影响肺癌患者生存的危险因素。应加强术前、术后血糖控制并改善肺通气,以降低ARDS发生几率。