老年乳腺癌患者化疗期间消化道反应的高危因素Logistic分析

A Logistic analysis on high risk factors for gastrointestinal response to chemotherapy in elderly breast cancer patients

[目的]研究老年乳腺癌患者化疗期间消化道反应的危险因素,以期为临床诊治提供参考。[方法]回顾性分析经病理确诊且采用联合化疗及支持治疗的190例老年乳腺癌患者的临床资料。采用安德森症状评估量表中文版(MDASI-C)进行调查,按照消化道反应分为无或轻度患者155例(对照组),中度或重度患者35例(研究组)。应用单因素分析老年乳腺癌患者化疗期间消化道反应的影响因素,并采用多因素Logistic分析对上述有差异的统计学资料进行进一步回归分析,最终探讨影响其独立危险因素。[结果]190例患者发生中重度消化道反应35例,发生率18.42%。单因素分析显示,职业状态、文化程度、病程、疾病分期、化疗方案、化疗次数、心理一致感是老年乳腺癌患者化疗期间消化道反应的危险因素,差异有统计学意义(P<0.05)。多因素分析显示,病程、化疗次数、心理一致感均为老年乳腺癌患者化疗期间消化道反应的独立危险因素,差异有统计学意义(P<0.05)。[结论]老年乳腺癌化疗期间消化道反应的危险因素较多,而其病程、化疗次数、心理一致感等是高危因素,临床上针对此类患者应加强重点监测。

[Objective]To investigate the risk factors of gastrointestinal reactions during chemotherapy in elderly patients with breast cancer, and to provide a reference for clinical diagnosis and treatment.[Methods]A total of 190 elderly patients with breast cancer treated in our hospital during February 2020 and February 2022 were retrospectively enrolled, and all patients were pathologically confirmed and treated with combined chemotherapy and supportive care.Using the Chinese version of Anderson symptom assessment scale(mdasi-c),155 patients were classified as none or mild(control group),and 35 patients as moderate or severe(Study Group)according to gastrointestinal reactions.Univariate analysis was used to analyze the influencing factors of gastrointestinal response during chemotherapy in elderly patients with breast cancer, and multivariate Logistic analysis was used to further regression analysis with the above differential statistical data to finally explore the influencing independent risk factors.[Results]Moderate to severe gastrointestinal reactions occurred in 35 out of 190 elderly patients with breast cancer(18.42%).Univariate analysis showed that occupational status, education level, disease duration, disease stage, chemotherapy regimen, number of chemotherapy sessions, and psychological consistency were risk factors for gastrointestinal reactions during chemotherapy in elderly patients with breast cancer, with statistically significant differences(P<0.05).When the above univariate analysis with differences was included in the multivariate analysis, disease duration, number of chemotherapy sessions, and psychological consistency were all independent risk factors for gastrointestinal reactions during chemotherapy in elderly patients with breast cancer, and the differences were statistically significant(P<0.05).[Conclusion]There are many risk factors for gastrointestinal reactions during chemotherapy for breast cancer in the elderly, including the course of the disease, the number of chemotherapy sessions, and psychological consistency, and so on, and focused monitoring should be enhanced for such patients when they are clinically targeted.