目的探讨老年肺癌合并静脉血栓栓塞症(VTE)的临床特点、危险因素及预后,提高防治意识,减少血栓事件发生。方法对北京医院2003年1月至2013年4月老年肺癌合并VTE的患者进行回顾性临床分析,记录年龄、性别、临床表现、病理类型、TNM分期、体力状态(PS)评分、化疗方案及预后等临床信息。结果老年肺癌组49例,年龄(72.8±5.56)岁,非老年组30例,年龄(54.2±8.29)岁。老年组基础疾病的发生率高于非老年组;近期卧床(24.49%对6.67%)和PS评分(2.32±1.38对1.37±1.10)亦高于非老年组(P值分别为0.048和0.02)。在两组患者中,以NSCLC为主,病理类型多为腺癌,TNM分期Ⅲ~Ⅳ期居多。老年组呼吸困难症状(36.74%对13.33%)及肺栓塞严重程度指数(PESI)评分(116.92±21.34对100.5±18.12)多于非老年组(P值分别为0.028和0.04)。老年肺癌组3、6、9和12个月VTE累积发生率分别为71.4%、77.6%、83.7%和87.8%;非老年组分别为76.7%、80.0%、83.3%和83.3%。生存分析显示,两组中位生存时间差异无统计学意义[(6.0±2.25)个月对(9±7.48)个月,P=0.657]。结论老年肺癌合并VTE患者具有较多的基础疾病,而且卧床患者较多;老年组PTE患者中呼吸困难症状多见,疾病危险程度高于非老年组,老年组患者预后较非老年组差。 Objective To investigate the clinical features, risk factors and prognosis of elderly patients with lung cancer complicated with venous thromboembolism (VTE), and to improve their awareness of prevention and treatment and to reduce the occurrence of thrombotic events. Methods The clinical data of patients with lung cancer complicated with VTE from January 2003 to April 2013 in Beijing Hospital were retrospectively analyzed. The age, gender, clinical manifestations, pathological type, TNM stage, physical status (PS) score, chemotherapy regimen and prognosis Other clinical information. Results 49 elderly patients with lung cancer (72.8 ± 5.56) years old, 30 cases of non-elderly group, age (54.2 ± 8.29) years old. The incidence of underlying diseases in the elderly group was higher than that in the non-elderly group. The bedridden (6.69% versus 6.67%) and PS score (2.32 ± 1.38 vs 1.37 ± 1.10) were also higher in the elderly group than in the non-elderly group (P = 0.048 and 0.02, respectively). In the two groups of patients, NSCLC was the main pathological type of adenocarcinoma, TNM staging Ⅲ to Ⅳ mostly. The symptoms of dyspnea (36.74% vs 13.33%) and PESI score (116.92 ± 21.34 vs 100.5 ± 18.12) in the elderly group were more than those in the non-elderly group (P = 0.028 and 0.04, respectively). The cumulative incidence of VTE was 71.4%, 77.6%, 83.7% and 87.8% in elderly patients with lung cancer at 3, 6, 9 and 12 months respectively, and 76.7%, 80.0%, 83.3% and 83.3% in non-elderly patients. Survival analysis showed no significant difference in median survival between the two groups (6.0 ± 2.25 months vs. 9 ± 7.48 months, P = 0.657). Conclusions Elderly patients with lung cancer complicated with VTE have more underlying diseases and more bedridden patients. The symptoms of dyspnea in PTE patients are more common in elderly patients and the risk of disease is higher than that in non-elderly patients. The prognosis of elderly patients is worse than that of non-elderly patients.