乳腺癌患者化疗后认知功能变化及其相关因素分析

Cognitive function change after chemotherapy and related factors in patients with breast cancer

目的研究乳腺癌患者化疗前后认知功能的变化,探讨与认知功能变化的相关因素。方法前瞻性收集遂宁市中心医院2017年3月9日至2018年5月31日确诊为乳腺癌且接受化疗的179例患者,采用FACT-Cog量表评估化疗前后的认知功能水平,将化疗后认知评分较化疗前降低≥20%的120例患者作为认知功能降低组,余59例患者归为认知功能未降低组,采用二分类Logistic回归法分析认知功能下降的相关因素。结果179例患者化疗后认知功能评分为(109.3±21.1)分,显著低于化疗前评分的(124.1±17.9)分,差异有显著统计学意义(P<0.01);单因素分析结果显示,患者年龄、教育水平、肿瘤分期、化疗方案和化疗周期与化疗后认知功能的下降显著相关(P<0.01);多因素二分类Logistic回归分析结果显示,教育水平、化疗方案和化疗周期是乳腺癌患者化疗后认知功能下降的独立相关因素(P<0.05)。结论乳腺癌患者化疗后认知水平明显下降,患者的年龄、化疗方案和周期数是影响认知功能的独立危险因素,教育水平越高发生认知功能降低的风险降低,临床中应加强对该类患者的评估与管理。

Objective To investigate the changes of cognitive function before and after chemotherapy in patients with breast cancer,and to explore its related factors of cognitive function change.Methods A total of 179 patients diagnosed as breast cancer in Suining Central Hospital between March 9,2017 and May 31,2018,who received chemotherapy,were prospectively enrolled in this study.Cognitive function was measured by FACT-Cog scale before and after the chemotherapy.Among the 179 patients,120 were clarified as cognitive decline group for the decrease of cognitive score over and equal to 20%after the chemotherapy,and 59 were clarified as cognitive stably group.Logistic regression method was used to identify the factors related to the change in cognitive function.Results The cognitive function score of enrolled 179 patients after chemotherapy was(109.3±21.1)points,significantly lower than(124.1±17.9)points before chemotherapy(P<0.01).Univariate analysis showed that age,education level,tumor stage,chemotherapy regimen,and chemotherapy cycle were significantly correlated with the decline of cognitive function after chemotherapy(P<0.01).Multivariate logistic regression analysis showed that education level,chemotherapy regimen,and chemotherapy cycle were independent related factors for cognitive decline in breast cancer patients after chemotherapy(P<0.05).Conclusion Cognitive level of breast cancer patients decreased significantly after chemotherapy.Age,chemotherapy regimen,and cycle number of patients were independent risk factors affecting cognitive function.Patients with a higher level of education were associated with a lower risk of cognitive function reduction.Clinical evaluation and management of these patients should be strengthened.