雄激素剥夺治疗的前列腺癌患者癌因性疲劳状态及其影响因素

Analysis of Cancer-Related Fatigue in Prostate Cancer Patients with Androgen Deprivation Therapy

目的探讨单纯接受雄激素剥夺治疗(androgen deprivation therapy,ADT)的前列腺癌患者癌因性疲劳(cancer-related fatigue,CRF)的状态及其影响因素。方法便利抽样选择2015年4月至2017年9月期间解放军第九四医院泌尿外科符合条件的174例接受ADT治疗的前列腺癌患者为研究对象,应用简化疲劳量表进行CRF评估,同时应用视觉模拟量表进行疼痛强度评估,应用医院焦虑抑郁量表进行焦虑、抑郁评估,应用国际前列腺评分进行泌尿系症状评分。结果本组患者中度CRF者76例(43.7%),重度CRF者33例(19.0%)。单因素分析显示,合并症、疼痛、泌尿系症状、焦虑和抑郁是影响中重度CRF的危险因素(均P<0.05);Logistic多元回归分析显示,中重度疼痛、抑郁是影响患者中重度CRF的独立危险因素(均P<0.05)。结论 ADT治疗的前列腺癌患者具有较重的疲劳感,疼痛和抑郁是影响CRF的独立危险因素,采取有效的护理措施控制疼痛和抑郁将有助于降低患者的CRF水平。

Objective To investigate the status of cancer-related fatigue（CRF）and its influencing factors in prostate cancer patients with androgen deprivation therapy（ADT）.Methods By convenience sampling method,174 prostate cancer patients were selected and assessed by using brief fatigue inventory scale.The visual analogue scale was used to evaluate the pain intensity and the hospital anxiety,and depression scale was used to evaluate the anxiety and depression level.International prostate symptom score was used to evaluate the urinary symptoms.Results Among 174 participants,76 cases（43.7%）showed moderate fatigue and 33 cases（19.0%）showed severe fatigue.Univariate analysis showed that comorbidity,pain,urinary symptoms,anxiety and depression were risk factors for moderate-to-severe CRF（all P〈0.05）.Logistic multivariate regression analysis showed that moderate-to-severe pain and depression were the independent risk factors for moderate-to-severe CRF（all P〈0.05）.Conclusions Prostate cancer patients treated with ADT have severe fatigue.Pain and depression are the independent risk factors for CRF.Taking effective countermeasures to control pain and depression will help to reduce the patient＇s fatigue level.