目的 本研究旨在探讨外周血淋巴细胞绝对计数(ALC)及其他检测指标与肺癌患者重度免疫检查点抑制剂相关肺炎(CIP)的危险因素及CIP患者预后的关系.方法 回顾性分析昆明医科大学第二、三附属医院2019年1月1日至2022年6月1日符合纳入标准的40例轻度CIP患者和24例重度CIP患者.通过Logistic回归模型分析探究重度CIP的影响因素;采用Kaplan-Meier法绘制不同指标与CIP患者预后的相关函数;使用Cox比例风险模型分析影响CIP患者预后的因素.结果 多因素Logistic回归分析结果提示低水平ALC是重度CIP发生的独立危险因素(P<0.05);Kaplan-Meier分析结果提示低水平ALC的患者较高水平ALC患者预后不佳,多因素Cox风险比例模型分析结果提示CIP发生时重度CIP患者预后不佳(P<0.05).结论 CIP发生时,低水平ALC是重度CIP发生的高危因素,低水平ALC患者预后较差,重度CIP是CIP患者预后不佳的高危因素.
Objective To investigate the relationship between absolute lymphocyte count(ALC)and other assays and risk factors for severe immune checkpoint inhibitor associated pneumonia(CIP)in lung cancer patients and the prognosis of patients with CIP.Methods 40 patients with mild CIP and 24 patients with severe CIP who met the inclusion criteria from January 1,2019 to June 1,2022 in the Second and Third Affiliated Hospitals of Kunming Medical University were retrospectively analyzed.Exploring the influencing factors of severe CIP by Logistic regres-sion model analysis;Plotting the correlation function between different indicators and the prognosis of CIP patients by Kaplan-Meier method;Analyzing the factors affecting the prognosis of CIP patients using Cox proportional risk model.Results The results of multi-factor Logistic regression analysis suggested that low-level ALC was an independent risk factor for the development of severe CIP(P<0.05);the results of Kaplan-Meier analysis suggested that patients with low-level ALC had a poorer prognosis than patients with high-level ALC,and the results of multi-factor Cox risk-pro-portional modeling suggested that the prognosis of patients with severe CIP at the time of CIP was poor(P<0.05).Conclusion At the time of CIP,low-level ALC was a high risk factor for the development of severe CIP,and pa-tients with low-level ALC had a poorer prognosis,while severe CIP was a high risk factor for poor prognosis in patients with CIP.