摘要
目的分析接受化疗的乳腺癌患者在不同治疗阶段癌因性疲乏(CRF)的特征,并探讨其影响因素。方法本研究为纵向调查性研究。采用便利抽样法纳入2023-01-01-06-30山东省肿瘤医院200例接受全身化疗的乳腺癌患者,采用一般资料调查表、癌症疲乏量表、汉密顿焦虑量表、汉密顿抑郁量表和匹兹堡睡眠质量指数量表调查患者首次化疗前、第1~6次化疗后共7个时间点CRF的发生情况及严重程度,使用重复测量的方差分析及配对t检验对化疗期各时点的疲乏程度进行分析,并采用非条件logistic回归分析CRF的影响因素。结果最终完成全程随访的研究对象共180例,失访率为10.00%(20/200)。接受首次化疗的乳腺癌患者CRF发生率为37.78%~63.33%。疲乏程度以轻度为主,随着化疗的进行,CRF的发生率及程度均呈上升趋势,第4次化疗后CRF程度(2.27±2.58)最严重,随后CRF的发生率及严重程度趋于平缓。进一步分析第4次化疗后CRF的影响因素发现,身体质量指数异常(OR=1.29,95%CI:1.02~1.44,P=0.020)、焦虑(OR=1.16,95%CI:1.02~1.40,P=0.017)、抑郁(OR=1.37,95%CI:1.11~1.58,P=0.001)和呕吐(OR=1.15,95%CI:1.01~1.43,P=0.001)为乳腺癌患者CRF的危险因素。结论乳腺癌患者在化疗过程中CRF波动幅度增大,第4次化疗后CRF程度最为严重。患者身体质量指数异常、焦虑、抑郁和呕吐是影响CRF的重要危险因素。
Objective To analyze the characteristics of cancer-related fatigue(CRF)in breast cancer patients receiving chemotherapy at different treatment stages,and to explore its influencing factors.Methods In this longitudinal investigation,200breast cancer patients who received systemic chemotherapy in Shandong Cancer Hospital from January 1,2023 to June 30,2023were enrolled by convenient sampling.General data questionnaire,cancer fatigue scale,Hamilton anxiety scale,Hamilton depression scale and Pittsburgh sleep quality index scale were used to investigate the occurrence and severity of CRF at 7time points before the first chemotherapy and after the first to sixth chemotherapy.Repeated measurement analysis of variance and paired t test were used to analyze the degree of fatigue at each time point during chemotherapy.Stepwise logistic regression was used to analyze the influencing factors of CRF.Results A total of 180subjects were followed up,and the rate of lost follow-up was 10.00%(20/200).The incidence of CRF in breast cancer patients who received the first chemotherapy was 37.78%to 63.33%.The degree of fatigue was mainly mild,and the incidence and degree of fatigue increased with the chemotherapy,and the fatigue degree was the most serious after the fourth chemotherapy cycle(2.27±2.58),and then the incidence and severity of CRF tended to slow down.Further analysis of the influencing factors of CRF after the fourth cycle of chemotherapy showed that abnormal body mass index(OR=1.29,95%CI:1.02-1.44,P=0.020),anxiety(OR=1.16,95%CI:1.02-1.40,P=0.017),depression(OR=1.37,95%CI:1.11-1.58,P=0.001)and vomiting(OR=1.15,95%CI:1.01-1.43,P=0.001)were the risk factors of CRF in patients with breast cancer.Conclusions The fluctuation range of CRF in breast cancer patients will increase during chemotherapy,and the degree of CRF is the most serious after the fourth cycle of chemotherapy.Abnormal body mass index,anxiety,depression and vomiting are important risk factors for CRF.
作者
张欢
宋敏
于静
孟英涛
ZHANG Huan;SONG Min;YU Jing;MENG Yingtao(Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan,Shangdong250117,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2023年第24期1513-1518,共6页
Chinese Journal of Cancer Prevention and Treatment
基金
山东省中医药科技项目(Q-2022116)。
关键词
乳腺癌
化学治疗
癌因性疲乏
影响因素
breast cancer
chemotherapy
cancer-related fatigue
influencing factors
