去势治疗前列腺癌患者长期认知功能变化情况及相关因素分析  

Long-term cognitive function changes and related factors in patients with prostate cancer treated byandrogen deprivation therapy

作　　者：李萍[1] 陈建霞[1] 陈静[1] 金珍珍[1] 吴蓉蓉[1] 钱蓉 Li Ping;Chen Jianxia;Chen Jing;Jin Zhenzhen;Wu Rongrong;Qian Rong(Department of Urology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325006,China)

机构地区：[1]温州医科大学附属第一医院泌尿外科,温州325006

出　　处：《中华现代护理杂志》2021年第33期4531-4536,共6页Chinese Journal of Modern Nursing

基　　金：温州市科技局项目(Y20190323)。

摘　　要：目的调查去势治疗(ADT)前列腺癌患者长期认知功能的变化情况,并分析其相关因素。方法采用前瞻性观察性队列研究的方法,选取2016年4月—2018年4月温州医科大学附属第一医院收治的131例非转移性前列腺癌患者为研究对象,将接受ADT的患者设为ADT组,将未采用ADT的患者设为非ADT组。采用一般情况调查表、蒙特利尔认知评估基础量表(MoCA-B)、患者健康问卷抑郁症状群量表(PHQ-9)及中文版癌症治疗功能评估-认知功能量表(FACT-Cog)进行调查,纵向比较两组患者入院时、6个月后、12个月后、24个月后的认知功能情况变化,并通过多因素回归分析接受ADT前列腺癌患者认知功能变化的相关因素。结果24个月随访结束时共123例患者完成调查,其中ADT组55例,非ADT组68例。ADT组患者入组时、6个月、12个月和24个月的FACT-Cog得分分别为(110.3±10.2)、(107.6±10.2)、(106.1±9.9)、(103.1±9.5)分,非ADT组患者入组时、6个月、12个月和24个月的FACT-Cog得分分别为(111.1±10.0)、(108.7±10.3)、(107.0±9.4)、(106.4±9.5)分。多因素分析显示,治疗方式、年龄、PHQ-9得分是前列腺癌患者认知功能下降的影响因素(P<0.05)。结论长期接受ADT的前列腺癌患者认知功能随着时间的推移有所下降,ADT、老龄化和抑郁状况是认知功能下降的主要独立危险因素,提示护理工作者应早期关注患者的认知功能变化,针对危险因素予以护理干预以改善患者的认知情况。Objective To investigate changes in long-term cognitive function of patients with prostate cancer treated by androgen deprivation therapy(ADT)and analyze its related factors.Methods Using a prospective cohort study method,a total of 131 patients with non-metastatic prostate cancer who were admitted to the First Affiliated Hospital of Wenzhou Medical University from April 2016 to April 2018 were selected as the research objects.The patients who received ADT were set as the ADT group and the patients who did not use ADT were set as the non-ADT group.General Situation Questionnaire,Montreal Cognitive Assessment Basic Scale(MoCA-B),Patient Health Questionnaire(PHQ-9)and Chinese version of Functional Assessment of Cancer Therapy-Cognitive Function(FACT-Cog)were used to investigate.Longitudinal comparisons of patients were made between the two groups on admission,6 months later,12 months later and 24 months later.Multivariate regression analysis was conducted to analyze factors associated with cognitive changes in prostate cancer patients receiving ADT.Results At the end of the 24-month follow-up,a total of 123 patients had completed the investigation,including 55 in the ADT group and 68 in the non-ADT group.The FACT-Cog scores of patients in the ADT group were respectively(110.3±10.2),(107.6±10.2),(106.1±9.9)and(103.1±9.5)at the time of enrollment,6 months,12 months and 24 months.The FACT-Cog scores of patients in the non-ADT group were respectively(111.1±10.0),(108.7±10.3),(107.0±9.4)and(106.4±9.5)at the time of enrollment,6 months,12 months and 24 months.Multivariate analysis showed that treatment,age and PHQ-9 score were the influencing factors of cognitive decline in prostate cancer patients(P<0.05).Conclusions The cognitive function of prostate cancer patients who have received ADT for a long time has declined over time.ADT,aging and depression are the main independent risk factors for cognitive decline,suggesting that nursing workers should pay attention to changes of cognitive function of patients at ea

关 键 词：前列腺肿瘤 去势治疗 认知功能 影响因素 

分 类 号：R473.73[医药卫生—护理学]