年轻乳腺癌患者内分泌治疗期间性功能障碍状况及其影响因素

Status and influencing factors of sexual dysfunction in young breast cancer patients during endocrine therapy

目的分析内分泌治疗期间年轻乳腺癌患者女性性功能障碍(female sexual dysfunction,FSD)的发生状况及其影响因素。方法选取2021年1月至2021年7月于上海交通大学医学院附属瑞金医院进行术后辅助内分泌治疗的189例年轻女性乳腺癌患者为研究对象,采用一般资料调查表、女性性功能指数量表、乳腺癌患者身体意象量表、医院焦虑抑郁量表、社会支持评定量表及修订版婚姻调适量表进行调查。采用logistic回归分析FSD的影响因素。结果在189例年轻女性乳腺癌患者中,FSD发生率为81.0%(153/189)。多因素分析结果显示,乳房重建术相比乳房切除术可以降低FSD的发生风险(OR=0.243,95%CI:0.076~0.779,P=0.017);术后身体意象评分≥8分是FSD的保护因素(OR=0.176,95%CI:0.059~0.526,P=0.002);而曾接受化疗(OR=5.250,95%CI:2.065~13.347,P<0.001)、存在焦虑症状(OR=6.348,95%CI:1.985~20.299,P=0.002)是FSD的独立危险因素。结论年轻女性乳腺癌患者在内分泌治疗期间的FSD发生率较高,尤其是曾接受化疗、存在焦虑症状、身体意象状况较差的患者,需重视患者的性健康问题并加强性功能评估,以便进行针对性干预。

Objective To analyze the current occurrence and influencing factors of female sexual dysfunction(FSD)in young breast cancer patients during endocrine therapy.Methods A total of 189 young female breast cancer patients who underwent posto-perative adjuvant endocrine therapy in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from January 2021 to July 2021 were selected as the research subjects.The general information questionnaire,female sexual function index scale(FSFI),body image scale for breast cancer patients(BIS),hospital anxiety and depression scale(HADS),social science research solutions(SSRS)and the revised dyadic adjustment scale(RDAS)were collected and analyzed.Logistic regression was used to analyze the influencing factors of FSD.Results Among 189 young female breast cancer patients,the incidence of FSD was 81.0%(153/189).Multivariable analysis showed that breast reconstruction reduced the risk of FSD,compared with mastectomy(OR=0.243,95%CI:0.076-0.779,P=0.017).Postoperative BIS score≥8 was a protective factor for FSD(OR=0.176,95%CI:0.059-0.526,P=0.002).Previous chemotherapy(OR=5.250,95%CI:2.065-13.347,P<0.001)and anxiety(OR=6.348,95%CI:1.985-20.299,P=0.002)were independent risk factors for FSD.Conclusions Young female breast cancer patients have a higher incidence of FSD during endocrine therapy,especially in the patients who have been treated with chemotherapy,have anxiety disorders and poor body image.It is necessary to pay attention to patients'sexual health issues and strengthen the assessment of patients'sexual function by carrying out targeted intervention.