CAJ | 학술논문

目的：探讨影响脊柱转移性肿瘤患者生存的相关因素。方法收集2011年1月至2013年3月粤北人民医院和李嘉诚基金会宁养院226例脊柱转移性肿瘤患者的临床资料，采用Kaplan-meier法进行生存分析，调查性别、家庭人均收入情况、是否吸烟、单/多发椎体转移、是否合并其他部位转移、治疗状况等11项临床指标与患者生存的关系，采用COX风险回归模型进行多因素分析，筛选影响生存的主要相关因素。结果226例脊柱转移性肿瘤患者3、6、12、18个月的生存率分别为81.9%、75.7%、69.5%、65.9%；家庭人均月收入、是否吸烟、椎体转移数量、是否合并其他部位转移、是否治疗、对肿瘤的态度等6个变量与患者生存期存在相关关系（P＜0.05）；是否吸烟、椎体转移数量、是否治疗以及对肿瘤的态度是影响脊柱转移性肿瘤患者生存的独立危险因素。结论吸烟、治疗状况，椎体转移数量以及对肿瘤的态度等对脊柱转移性肿瘤患者生存有重要影响，可以作为预后指标来指导临床治疗。
목적：탐토영향척주전이성종류환자생존적상관인소。방법수집2011년1월지2013년3월월북인민의원화리가성기금회저양원226례척주전이성종류환자적림상자료，채용Kaplan-meier법진행생존분석，조사성별、가정인균수입정황、시부흡연、단/다발추체전이、시부합병기타부위전이、치료상황등11항림상지표여환자생존적관계，채용COX풍험회귀모형진행다인소분석，사선영향생존적주요상관인소。결과226례척주전이성종류환자3、6、12、18개월적생존솔분별위81.9%、75.7%、69.5%、65.9%；가정인균월수입、시부흡연、추체전이수량、시부합병기타부위전이、시부치료、대종류적태도등6개변량여환자생존기존재상관관계（P＜0.05）；시부흡연、추체전이수량、시부치료이급대종류적태도시영향척주전이성종류환자생존적독립위험인소。결론흡연、치료상황，추체전이수량이급대종류적태도등대척주전이성종류환자생존유중요영향，가이작위예후지표래지도림상치료。
Objective To investigate the relative impact factors for survival of patients with spinal metastatic tumor. Methods Clinical data of 226 patients with spinal metastatic tumor treated in Yuebei People’s Hospital and the Hospice of Li ka-shing Foundation from January 2011 to March 2013 were collected and analyzed retrospectively. Survival analysis were undergone by Kaplan-meier method to investigate the relations of survival of patients and 11 items of clinical parameters such as gender, household incomes per capita, smoking, single/multiple vertebral metastasis, metastasis locations, therapy condition and so on. Then the prognostic factors were screened based on multi-analysis according to COX proportional hazard regression model. Results The survival rate of 3, 6, 12, and 18 months after the surgery were 81.9%, 75.7%, 69.5% and 65.9% respectively. Kaplan-meier survival analysis results showed that 6 variables were related to survival time of patients including household incomes per capita, whether smoking, metastatic vertebral number, whether there were other metastasis sites, whether to treat and psychological acceptance to tumor (P <0.05), and COX proportion hazard regression model analysis indicated that smoking, therapy condition, metastatic vertebral nubmer and attitude to tumor were independent risk factors for the prognosis. Conclusion Smoking, therapy conditions, metastatic vertebral number and psychological acceptance to tumor are the main risk factors affecting the survival of patients with spinal metastatic tumor, which can be used as prognostic indicators and guidance for clinical treatment.