乳腺癌患者化疗药品不良反应影响因素研究

Influencing factors of chemotherapy related adverse drug reactions in breast cancer patients

目的 探究乳腺癌患者化疗药品不良反应(ADR)的发生率和影响因素,为其防治提供科学依据。方法 回顾性分析2020-01-01-2022-12-31在山东第一医科大学附属肿瘤医院行化疗的乳腺癌患者临床资料。收集社会人口学特征、体格检查和健康状况等信息,共纳入5 431例患者。采用多因素非条件logistic回归分析乳腺癌患者化疗ADR的影响因素。结果 在5 431例乳腺癌患者中,93例患者发生ADR,发生率为1.7%。多因素二分类logistic回归调整多种混杂因素后结果显示,患者过敏史(OR=2.36,95%CI:1.20~4.62)和疼痛程度(OR=1.06,95%CI:1.01~1.11)与ADR有关联,差异均有统计学意义,χ^(2)值分别为6.300和4.040,P值分别为0.012和0.041。分层分析结果显示,<60岁患者过敏史(OR=2.37,95%CI:1.12~5.03)和疼痛程度(OR=1.06,95%CI:1.01~1.11)与ADR发生风险有关联,差异有统计学意义,χ^(2)值分别为5.198和4.203,P值分别为0.024和0.043。在使用多西他赛和表柔比星的患者中,患者疼痛程度与ADR发生风险的OR值分别为1.80(95%CI:1.14~2.83)和5.54(95%CI:1.59~19.31),差异均有统计学意义,χ^(2)值分别为6.401和8.468,P值分别为0.011和0.007。结论 乳腺癌化疗患者的过敏史和疼痛程度与ADR发生风险存在关联,临床医护人员需针对不同人群采取个性化的治疗措施。

Objective To explore the incidence and influencing factors of adverse drug reactions(ADR)in breast cancer patients undergoing chemotherapy.providing scientific evidence for their prevention and treatment.Methods Clinical data of breast cancer patients who were treated with chemotherapy at the Affiliated Shandong Cancer Hospital and Institute of Shandong First Medical University from January 1,2020 to December 31,2022 were retrospectively analyzed.Information on socio-demographic characteristics,physical examination and health status was collected,and 5431 patients were finally included.Multifactorial unconditional logistic regression analysis was used to analyze the influencing factors of ADR during chemotherapy in breast cancer patients.Results Among 5431 breast cancer patients,ADR occurred in 93 patients,with an incidence of 1.7%.The results of multifactorial binary logistic regression analysis,adjusted for multiple confounding factors showed that patient history of allergy(OR=2.36,95%CI:1.20-4.62)and pain level(OR=1.06,95%CI:1.01-1.11)were associated with ADR with chi-square values of 6.300 and 4.040 and P-values of 0.012 and O.04l,respectively.The differences were all statistically significant.Stratified analysis showed that history of allergy(OR=2.37,95%CI:1.12-5.03)and pain level(OR=1.06,95%CI:1.01-1.11)were associated with the risk of ADR in patients<60 years of age,with chi-square values of 5.198 and 4.203,and P-values of 0.024 and 0.043,with the difference remaining statistically significant.In patients receiving docetaxel and epirubicin,the OR values for pain level in relation to the risk of ADRs were 1.80(95%CI:1.14-2.83)and 5.54(95%CI:1.59-19.31),with chi-square values of 6.401 and 8.468,and P-values of 0.01l and 0.007,respectively,and the differences were all statistically significant.Conclusion There is an association between history of allergy and level of pain in breast cancer patients undergone chemotherapy and the risk of ADRs,and clinical medical staff need to individualize treatment measures for different populations.