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T4、TSH、FT4 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T3、FT3、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T3<1.31 nmol/L、FT3<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T4、TSH、FT4 水平比较,差异无统计学意义(P>0.05);轻度术后谵妄患者T3、FT3 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:T3、FT3 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T3、FT3、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.
Abstract
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 sur-gery 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(deliri-um 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 hor-mone,CRP/ALB,NLR and delirium after lung cancer surgery.Results There were no significant differenc-es between the two groups in terms of sex,hypertension,ASA grade,T4,TSH,FT4 levels and other indica-tors(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 can-cer(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 lev-els of CRP/ALB and NLR were lower than those in patients with severe postoperative delirium.These differ-ences were statistically significant(P<0.05).According to Pearson correlation analysis,T3 and FT3 were neg-atively correlated with postoperative delirium in lung cancer,and CRP/ALB and NLR were positively correlat-ed with postoperative delirium in lung cancer(P<0.05).Conclusion There is a correlation between postoper-ative T3,FT3,CRP/ALB,and NLR levels in lung cancer patients undergoing radical surgery and the occur-rence of postoperative delirium.Detecting the levels of these indicators can provide reference data for clinically evaluating the severity of postoperative delirium.
NETL
NSTL
维普
万方数据