Kupperman评价辅助化疗对乳腺癌患者更年期综合征的影响

Kupperman grading system to evaluate the effect of adjuvant chemotherapy on climacteric syndrome of breast cancer patients

目的采用改良Kupperman评分(KI)系统对乳腺癌化疗患者进行评分,评估辅助化疗对乳腺癌患者更年期综合征的影响。方法选取2013年12月至2015年4月间在西安交通大学第一附属医院肿瘤科因乳腺癌化疗的患者115例,对化疗前后Kupperman评分进行统计学分析。结果在有效回收问卷的104例患者中:①化疗后更年期综合征(KI≥6分)的发生率为88.46%(92/104),较化疗前50.96%(53/104)显著增加,与化疗前相比差异有统计学意义(x^2=34.63,P<0.01);②化疗后的Kupperman评分由术前的11.11±8.63分增加至15.85±10.30分(t=10.63,P<0.01),其中化疗后更年期综合征中度(KI为16~30分)和重度(KI>30分)者占66.30%(61/92),与化疗前32.08%(17/53)比较比例显著增加,差异有统计学意义(x^2=15.85,P<0.01);③化疗后性生活障碍、潮热出汗、疲乏、失眠、抑郁疑心和情绪波动的症状评分与化疗前相比,差异有统计学意义(t值分别为4.68、5.52、7.79、5.88、4.64、2.61,均P<0.05)。结论辅助化疗可增加女性乳腺癌化疗患者更年期综合征风险,个体化处理可能有助于降低女性乳腺癌患者更年期综合征发生的风险。

Objective To assess the effect of adjuvant chemotherapy on climacteric syndrome of breast cancer patients with modified Kupperman scoring system. Methods The study was conducted among 115 breast cancer patients undergoing chemotherapy during the period of December 2013 to April 2015 in the First Affiliated Hospital of Xi＇ an Jiaotong University. Kupperman scores were compared before and after chemotherapy. Results Questionnaires of 104 cases were collected successfully. The incidence of climacteric syndrome （ KI ≥6） after chemotherapy was 88.46% （92/104）, which increased significantly compared with that before chemotherapy （50.96%, 53/ 104） （X2 = 34.63 ,P 〈0.01 ）. Kupperman score increased from 11.11 ＋ 8.63 preoperatively to 15.85 ± 10.30 after chemotherapy （t = 10.63, P 〈 0.01 ）. The percentage of cases with moderate climacteric syndrome （ KI ranged 16 - 30） and severe climacteric syndrome （ KI 〉 30） after chemotherapy was 66.30% （61/92）, which was significantly higher than that before chemotherapy （ 32.08%, 17/53 ） （X2 = 15.85, P 〈 0.01 ）. There were statistical differences in symptom score in sexual dysfunction, hot flashes sweating, fatigue, insomnia, depression and emotional fluctuation before and after treatment （ t value was 4.68, 5.52, 7.79, 5.88, 4.64 and 2.61, respectively, all P 〈 0.05 ）. Conclusion Adjuvant chemotherapy can elevate the risk of climacteric syndrome among breast cancer patients. Individualized treatment and health education may he the effective measures to reduce the risk of climacteric syndrome of breast cancer patients.