小细胞肺癌患者低钠血症与预后关系的meta分析

《小细胞肺癌患者低钠血症与预后关系的meta分析》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、授予单位代码10089学号或申请号20153531中国图书分类号R734.2HebeiMedicalUniversity硕士学位论文专业学位小细胞肺癌患者低钠血症与预后关系的meta分析研究生：刘蕾导师：魏素菊教授专业：肿瘤学二级学院：第四医院2018年3月目录中文摘要····························································································1英文摘要··················································

2、··········································3研究论文小细胞肺癌患者低钠血症与预后关系的meta分析前言·····················································································5材料与方法··················································································5结果··································

3、···················································7附图·····················································································10附表·····················································································15讨论··················································

4、···································16结论·····················································································18参考文献···················································································18综述低钠血症在癌症中的研究进展················································22致谢

5、·····················································································33个人简历·····················································································34中文摘要小细胞肺癌患者低钠血症与预后关系的meta分析摘要目的：低钠血症是癌症患者常见的电解质紊乱之一。尤其在小细胞肺癌(SmallCellLungCancer，SCLC)患者中低钠血症发生率最高。最近的研究

6、评估低钠血症对肺癌患者预后的影响，发现低钠血症早期发现和适当的管理可以改善患者的预后。不幸的是，多数肺癌研究的数据不能结合并进行荟萃分析，因为大多数研究没有报告生存结果的风险比（hazardratio,HR）。然而，当这些数据一起考虑时，他们支持低钠血症是癌症患者的负面预后因素的假设。为了准确评估SCLC低钠血症是否与患者生存期相关，进而应用meta分析系统对已有证据进行系统、客观评价，以确定小细胞肺癌患者低钠血症与预后的相关性。方法：使用计算机全面检索Pumbmed、Embase、中国知网数据库、维普中文期刊数据及万方等数据库。纳入有关分析小细胞肺癌患者低

7、钠血症与预后关系的研究，最终共纳入文献8篇。应用Stata12.0软件进行分析，若所纳入文献存在异质性，应用随机效应模型分析；若所纳入文献不存在异质性，应用固定效应模型分析。结局指标为1年生存率、3年生存率、5年生存率和风险比（HR）及95%可信区间（95%CI），显著的临床异质性采用亚组分析或敏感性分析等方法进行处理。应用漏斗图检测其发表偏倚。Meta分析的检验水准设为α=0.05。结果：1.1年生存率分析结果显示，低钠组的生存率低于正常组（OR=6.65,95%CI:3.07~14.41,z=4.80,P=0.000）；2.3年生存率分析结果显示，低钠组

8、的生存率低于正常组（OR=4.96,95%CI:1.