康复期肺癌患者癌因性疲乏与神经内分泌关系的初步研究  

Relationship between the neuroendocrine and cancer-related fatigue in convalescent lung cancer patients

作　　者：任维维[1,2] 李征[1,2] 米登海[1,2] 温志震 李忠信 刘小荣 

机构地区：[1]甘肃省第二人民医院,甘肃兰州730000 [2]兰州大学第一临床医学院,甘肃兰州730000

出　　处：《现代肿瘤医学》2013年第2期290-293,共4页Journal of Modern Oncology

基　　金：甘肃省卫生行业科研计划项目(编号:GSWST09-06);甘肃省自然科学研究基金项目(编号:1010RJZA162)

摘　　要：目的:观察肺癌康复期癌因性疲乏(cancer-related fatigue,CRF)患者血清甲状腺激素、促甲状腺激素、皮质醇和促肾上腺皮质激素的水平,初步探讨康复期肺癌患者癌因性疲乏与神经内分泌的关系。方法:按照纳入标准,纳入我院2009年1月-2012年3月59例康复期肺癌患者,分成疲乏组(39例疲乏患者)和非疲乏组(20例非疲乏患者),利用多维疲乏症状量表-简化版(multidimensional fatigue symptom inventory-short,MFSI-SF)和疲劳症状量表(fatigue symptom inventory,FSI)对疲乏患者的疲乏状况进行评估。采集患者清晨8∶00静脉血,电化学发光法检测甲状腺激素、促甲状腺激素、皮质醇的水平;酶联免疫吸附检测促肾上腺皮质激素的水平,并且用SPSS 19.0进行统计学分析。结果:疲乏组肺癌患者血清甲状腺素(T3,T4,FT3,FT4)、皮质醇水平均低于非疲乏组,差异均具有统计学意义(P<0.05),血清促肾上腺皮质激素高于非疲乏组,差异均具有统计学意义(P<0.05),血清促甲状腺激素差异无统计学意义(P>0.05);疲乏组患者MFSI-SF评分与甲状腺激素、皮质醇激素水平呈负相关(r=-0.893,-0.797,-0.717,-0.855,-0.820,P=0.000<0.05);疲乏组患者FSI评分与甲状腺激素、皮质醇激素水平呈负相关(r=-0.772,-0.659,-0.661,-0.653,-0.778,P=0.000<0.05);疲乏组患者MFSI-SF评分与促肾上腺皮质激素水平呈正相关(r=0.813,P=0.000<0.05),疲乏组患者FSI评分与促肾上腺皮质激素水平呈正相关(r=0.629,P=0.000<0.05)。结论:肺癌康复期癌因性疲乏患者血清甲状腺激素、皮质醇激素水平降低,促肾上腺皮质激素水平升高,血清激素的水平一定程度上影响患者疲乏的程度;促甲状腺激素水平正常,低水平的血甲状腺激素对促甲状腺激素的分泌不能有效的起到负反馈调节作用,促肾上腺皮质激素的分泌对低水平的血皮质醇激素有反应,但反应不敏感。Objective： To explore the relationship between the neuroendocrine and cancer - related fatigue （CRF）, and investigate the serum levels of thyrotropin, thyroid hormone, cortisol hormone and eorticotropin. Methods： A total of 59 lung cancer patients were included （39 cancer - related fatigue patients and 20 no fatigue patients）. 39 cancerrelated fatigue patients were investigated by muhidimensional fatigue symptom inventory -short （ MFSI - SF） and fatigue symptom inventory（FSI）. Serum specimens were collected at eight clocks and examined by electrical chemiluminescent immunoassay and enzyme - linked immunoadsordent assay. Results： The levels of thyroid hormone, corticotropin and cortisol hormone were significantly different between cancer - related fatigue patients and no cancer - related fatigue patients （ P 〈 0.05 ）, but no significant difference in thyrotropin （ P 〉 0.05 ） ; There were negutive correlations between the MFSI - SF and levels of thyroid hormone （ T3 , T4 , FT3 , FT4 ） , cortisol hormone （r = -0. 893, -0. 797, -0.717, -0. 855, -0. 855 ,P =0. 000 〈0.05 ） ,but positive correlations of corticotropin（ r = 0.813, P = 0. 000 〈 0. 05 ） ;There were negative correlations between the FSI and levels of thyroid hormone, cortisol hormone（ r = - 0. 772, - 0. 659, - 0.661, - 0. 653, - 0. 778, P = 0. 000 〈 0.05 ） , but positive correlations of corticotropin（ r = 0. 629,P = 0. 000 〈 0.05 ）. Conclusion： The concentration of thyroid hormone and cortisol hormone were low,the eorticotrophin were high and the thyrotropin were normal; The low level of thyroid hormone had little effect on the thyrotropin, but the cortisol hormone had more effect on the cortieotropin in lung cancer patients with cancer - related fatigue.

关 键 词：肺癌 癌因性疲乏 康复期 神经内分泌 

分 类 号：R734.2[医药卫生—肿瘤]