情绪障碍对肺癌初治患者化疗毒副作用的影响

Effect of emotional disorder on adverse effect in patients with lung cancer after primary chemotherapy

目的回顾性分析肺癌初治患者化疗期间相关毒副作用的发生情况,及相关危险因素,为临床降低化疗期间毒副作用发生率、加速患者康复提供依据。方法纳入2017年8月—12月在四川省某三甲医院胸部肿瘤科住院接受首次化疗的221例肺癌患者,详细记录每位患者化疗期间的毒副作用发生情况,并了解患者的一般人口学资料和疾病状况,通过单因素和多因素logistic回归分析探索毒副作用发生的危险因素。结果肺癌初治患者化疗期间毒副作用发生率为40.3%,按发生率排序依次为恶心(23.5%)、食欲减退(10.9%)、呕吐(6.8%)、肝功能异常(5.4%)、骨髓抑制(5.4%)、便秘(5.0%)、过敏(3.2%)、腹痛(2.3%)、乏力(2.3%)、腹泻(1.8%)、头晕(1.4%)、咯血(1.4%)及发热(1.4%)。单因素分析结果显示,情绪障碍(P=0.027)、化疗方案(P=0.002)是毒副作用发生的影响因素,纳入多因素Logistic回归分析后结果显示,化疗前合并情绪障碍[OR 2.092(95%CI 1.070~4.091);P=0.031]是导致肺癌初治患者化疗期间毒副作用发生的独立危险因素。结论肺癌初治患者化疗期间毒副作用发生率高,恶心是最常见症状。化疗前合并情绪障碍是化疗期间毒副作用发生的独立危险因素。

Objective To retrospective analyze the incidence of adverse reaction and its related risk factors,in order to reduce the incidence of adverse reactions in clinic and provide basis for patients'recovery.Methods A cross-sectional study was conducted from August to December 2017 to screen 221 patients with lung cancer underwent primary chemotherapy.Adverse effects after chemotherapy were recorded in detail.Univariate analysis and multivariable logistic regression analysis were performed to identify patient characteristics and relevant disease conditions that were associated with adverse effects.Results The incidence of adverse effects in patients with lung cancer after primary chemotherapy was 40.3%.The main adverse effects were ranked as follows:nausea(23.5%),anorexia(10.9%),vomiting(6.8%),elevation of transaminase(5.4%),myelosuppression(5.4%),constipation(5.0%),allergy(3.2%),bellyache(2.3%),fatigue(2.3%),diarrhea(1.8%),dizziness(1.4%),hemoptysis(1.4%),and fever(1.4%)respectively.Univariate analysis showed that emotional disorder(the score of Huaxi Emotional-distress Index greater than 8)and chemotherapy regimen were significantly associated with adverse effects(P<0.05).After multivariable adjustment,emotional disorder[OR 2.092(95%CI 1.070~4.091),P=0.031]remained significantly associated with adverse effects in the final logistic regression model.Conclusion The incidence of adverse effects is high in patients with lung cancer after primary chemotherapy and nausea is the most common symptom,Emotional disorder is the independent risk factor of adverse effects.