妇科癌症患者认知功能损害及影响因素研究

摘要

Objective:To evaluate the prevalence and risk associated with cognition in women with gynecologic malignancies.Methods:Case-control study was conducted among 146 patients with gynecologic malignancies and 130 control subjects. Patients and control subjects were recruited from a tumor hospital and three communities in Guangzhou.They were queried using a functional assessment of cancer therapy-cognitive function(FACT-Cog), hospital anxiety and depression scale(HADS),Chinese version of the brief fatigue inventory(BFI-C).Results:The total score of FACT-Cog of study group was 108.81 ± 24.54.Control group was 121.33 ± 21.53.The scores of study group were lower than healthy controls in the FACT-Cog total score and each dimension(PCI,PCA,Other,QOL). There were significant differences between two groups in the scores of FACT-Cog,PCI,PCA(P<0.05).21.9% of patients had cognitive impairment in study group and healthy controls was 8.5%.Single factor analysis results showed that chemotherapy,cancer stage,occupational status,anxiety,depression and fatigue were associated with perceived cognitive disturbances(P<0.05).Multiple linear regression analysis results showed that overall cognitive disturb-ances was associated with chemotherapy(β= -0.303,P<0.01)and depression(β= -0.449,P<0.01).Conclu-sion:Study findings indicate that the incidence rate of cognitive impairment in patients with gynecologic malignancies is high.Chemotherapy,anxiety,depression and fatigue are associated with cognitive impairment.Chemotherapy and de-pression could be important factors contributing to the development of cognitive impairment.%目的:了解妇科癌症患者认知功能损害情况及分析其影响因素.方法:收集广州市某肿瘤医院妇科恶性肿瘤患者146例,同期按年龄、文化程度进行匹配,选取广州市三个社区的健康成年女性130例作为对照组.用中文版FACT-Cog量表、医院焦虑抑郁量表(HADS)、中文版简明疲劳量表(BFI-C)进行问卷调查.结果:研究组FACT-Cog总分为(108.81 ± 24.54)分,对照组为(121.33 ± 21.53)分,研究组在FACT-Cog总分及各维度(PCI、PCA、Other、QOL)得分均低于对照组,且在FACT-Cog总分、PCI、PCA方面差异有统计学意义(P<0.05);研究组认知障碍发生率为21.9%,健康对照组为8.5%.单因素分析结果显示,化疗、癌症分期、就业状态、焦虑和抑郁状况、疲劳与认知功能损害的发生有关(P<0.05).多元线性回归分析结果显示,总体认知功能得分与化疗(β= -0.303,P<0.01)及抑郁(β= -0.449,P<0.01)呈负相关.结论:妇科癌症患者的认知障碍发生率较高,认知功能损害与化疗、焦虑、抑郁及疲劳存在相关性,化疗和抑郁是主要的危险因素.