子宫内膜癌术后化疗患者癌因性疲乏情况及严重程度的影响因素

Influence factors of cancer-related fatigue and its severity in chemotherapeutic patients after endometrial cancer surgery

目的 探讨子宫内膜癌术后化疗患者癌因性疲乏(CRF)情况及严重程度的影响因素。方法 收集122例子宫内膜癌术后化疗患者的病历资料,分别采用Piper疲乏量表(PFS)、医院焦虑抑郁量表(HAD)、社会支持评定量表(SSRS)及阿森斯失眠量表(AIS)评估患者的疲乏情况、焦虑抑郁情况、社会支持情况及睡眠质量。采用Pearson相关分析法分析HAD、SSRS、AIS评分与子宫内膜癌术后化疗患者CRF的相关性,采用多因素Logistic回归模型分析子宫内膜癌患者CRF严重程度的影响因素,采用受试者工作特征(ROC)曲线及曲线下面积(AUC)评估HAD、AIS、SSRS评分单独及三者联合对子宫内膜癌术后化疗患者CRF严重程度的预测价值。结果 PFS量表中行为、情感、感觉、认知/情绪维度及整体CRF均以中度CRF占比最高,分别为54.10%、45.90%、58.20%、47.54%、59.02%。HAD、AIS评分与子宫内膜癌术后化疗患者的CRF均呈正相关(P﹤0.05),SSRS评分与子宫内膜癌术后化疗患者的CRF呈负相关(P﹤0.05)。HAD评分﹥7分、SSRS评分﹤20分、AIS评分≥4分均是子宫内膜癌术后化疗患者CRF严重程度的独立危险因素(P﹤0.05)。HAD、AIS、SSRS评分单独及三者联合预测子宫内膜癌术后化疗患者CRF严重程度的AUC分别为0.753、0.682、0.865、0.961,其中三者联合的AUC最大。结论 子宫内膜癌术后化疗患者易发生CRF,而HAD、AIS、SSRS评分可作为评估术后化疗患者CRF严重程度的指标。

Objective To explore the influence factors of cancer-related fatigue(CRF) and its severity in chemotherapeutic patients after endometrial cancer surgery. Method The clinical data of 122 chemotherapeutic patients after endometrial cancer surgery were collected. The fatigue, anxiety and depression, social support and quality of sleep were evaluated by Piper fatigue scale(PFS), hospital anxiety and depression scale(HAD), social support rating scale(SSRS) and Athens insomnia scale(AIS) respectively. The correlation of CRF with HAD, SSRS and AIS scores were evaluated by Pearson analysis. The factors affecting the severity of CRF in endometrial cancer patients were analyzed by multivariate Logistic regression. The predicative value of single or combined HAD, AIS and SSRS scores in severity of CRF in chemotherapeutic patients after endometrial cancer surgery were evaluated by receiver operating characteristic(ROC) curve and area under the curve(AUC). Result The proportion of moderate CRF was the highest in terms of behavior, emotion,sense, cognition/mood and overall CRF situation in PFS, which was 54.10%, 45.90%, 58.20% 47.54% and 59.02%, respectively. HAD and AIS scores were positively correlated with CRF in chemotherapeutic patients after endometrial cancer surgery(P<0.05), SSRS score was negatively correlated with CRF in chemotherapeutic patients after endometrial cancer surgery(P<0.05). The scores of HAD>7, SSRS<20 and AIS≥4 were independent risk factors that affected the severity of CRF in chemotherapeutic patients after endometrial cancer surgery(P<0.05). The AUC of single and combined HAD, AIS, SSRS scores in predicating the severity of CRF in chemotherapeutic patients after endometrial cancer surgery were 0.753, 0.682, 0.865, 0.961, respectively, with the largest AUC for the combination detection. Conclusion The chemotherapeutic patients after endometrial cancer surgery are prone to having CRF. Scores of HAD, AIS, and SSRS can be used as relevant indicators to evaluate the severity of CRF.