肺癌患者化疗所致恶心呕吐的影响因素及预测分析-现代医学

肺癌患者化疗所致恶心呕吐的影响因素及预测分析

单位：南京医科大学附属淮安第一医院肿瘤内一科, 江苏淮安 223300

分类号：R473.73;R734.2

出版年·卷·期（页码）：2025·53·第三期（443-448）

摘要：

目的：探讨肺癌患者化疗所致恶心呕吐(CINV)的影响因素及预测模型。方法：回顾性纳入2022年1月至2024年6月肺癌患者158例，均接受化疗治疗，依据有无发生CINV分为CINV组(63例)与非CINV组(95例)。收集肺癌患者性别、体质量指数(BMI)、胃部疾病史、医院焦虑抑郁量表(HADS)得分、癌症疲乏量表(CFS)得分等资料。Logistic回归分析肺癌患者CINV的影响因素，并据上述影响因素构建预测模型，绘制受试者工作特征(ROC)曲线评估肺癌患者CINV预测模型的效能。结果： CINV组患者胃部疾病史比例、晕动病史比例、有营养风险比例、HADS得分、CFS得分均高于非CINV组(均P＜0.05)。Logistic回归分析显示，胃部疾病史(OR=3.795，95%CI:1.185～12.156)、晕动病史(OR=3.376，95%CI:1.237～9.214)、营养风险(OR=3.060，95%CI：1.140～8.212)、HADS得分(OR=1.308，95%CI=1.173～1.459)、CFS得分(OR=1.138，95%CI：1.083～1.218)是肺癌患者发生CINV的独立影响因素(均P＜0.05)。构建肺癌患者CINV预测模型为Logit(P)=-10.241+1.334×胃部疾病史(无=0，有=1)+1.217×晕动病史(无=0，有=1)+1.118×营养风险(无=0，有=1)+0.269×HADS得分+0.129×CFS得分。ROC曲线显示，该模型预测肺癌患者发生CINV的AUC为0.869，灵敏度为0.714，特异度为0.863，准确度为0.804。结论：胃部疾病史、晕动病史、营养风险、焦虑和抑郁症状、癌因性疲乏均为肺癌患者发生CINV的危险因素，据此构建的模型具有良好的预测效能，可为临床干预提供数据支持。

Objective: To investigate the influencing factors and predictive models of chemotherapy-induced nausea and vomiting(CINV) in patients with lung cancer. Methods: 158 patients with lung cancer who received chemotherapy from January 2022 to June 2024 were retrospectively selected and divided into CINV group(63 cases) and non-CINV group(95 cases), according to the presence or absence of CINV. Gender, body mass index(BMI), stomach disease history, scores of Hospital Anxiety and Depression Scale(HADS) and Cancer Fatigue Scale(CFS) were collected. Logistic regression analysis was conducted to analyze the influencing factors of CINV in lung cancer patients, and the predictive model was constructed according to the above influencing factors, and the receiver operating characteristic(ROC) curve was drawn to evaluate the efficacy of CINV prediction model in lung cancer patients. Results: The proportion of stomach disease history, motion sickness history, nutritional risk ratio, HADS score and CFS score in CINV group were higher than those in non-CINV group(all P<0.05). Logistic regression analysis showed that history of gastric diseases(OR=3.795, 95%CI 1.185-12.156), history of motion sickness(OR=3.376, 95%CI 1.237-9.214), nutritional risk(OR=3.060, 95%CI 1.140-8.212), HADS score(OR=1.308, 95%CI 1.173-1.459), and CFS score(OR=1.138, 95%CI 1.083-1.218) were independent risk factors for CINV in lung cancer patients(all P<0.05). The prediction model for CINV in lung cancer patients was constructed as: Logit(P)=-10.241+1.334×history of gastric diseases(no=0, yes=1)+1.217×history of motion sickness(no=0, yes=1)+1.118×nutritional risk(no=0, yes=1)+0.269×HADS score+0.129×CFS score. The ROC curve analysis showed that the model had an AUC of 0.869 for predicting CINV in lung cancer patients, with a sensitivity of 0.714, specificity of 0.863, and accuracy of 0.804. Conclusion: Gastric disease history, motion sickness history, nutritional risk, anxiety and depression symptoms, and cancer-related fatigue are all influencing factors for CINV in lung cancer patients. The model built based on this model has good predictive efficacy and can provide data support for clinical intervention.

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