乳腺癌患者芳香化酶抑制剂相关肌肉骨骼症状与运动恐惧的关系研究  

Study on aromatase inhibitor-related musculoskeletal symptoms and fear of exercise in breast cancer patients

作　　者：郑彬洁 郭晨明 杨美美[1] 王海燕[1] ZHENG Binjie;GUO Chenming;YANG Meimei;WANG Haiyan(Department of Breast Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院乳腺外科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2022年第3期276-280,共5页Journal of Xinjiang Medical University

基　　金：省部共建中亚高发病成因与防治国家重点实验室开放课题项目(SKL-HIDCA-2021-41)。

摘　　要：目的 探讨乳腺癌患者芳香酶抑制剂相关的肌肉骨骼症状(aromatase inhibitor associated musculoskeletal symptoms,AIMSS)与运动恐惧的相关性。方法 选择2017年4月-2019年7月在新疆医科大学第一附属医院接受治疗的乳腺癌患者300例,使用坦帕运动恐惧量表(TSK)对患者进行运动恐惧评估。采用西安大略和麦克马斯特大学骨关节炎指数(the western ontario and McMaster universities osteoarthritis index,WOMAC)调查问卷评估髋部和膝部的疼痛、僵硬和身体功能;采用臂肩手残疾调查问卷(disabilities of the arm,shoulder and hand questionnaire,DASH)评估上肢疼痛和身体功能。使用Wilcoxon秩和或Fishers精确检验对所有研究变量进行描述性统计和单因素分析,对P<0.15的变量进行Logistic多因素分析。结果 发生AIMSS的受试者发生运动恐惧的可能性更高[OR=2.29(95%CI:1.36~3.86),P=0.002]。发生AIMSS(139例)且发生运动恐惧(56例)的受试者髋部和膝部WOMAC,臂、肩和手DASH的功能评分下降差异均有统计学意义(P<0.05)。报告下肢疼痛[OR=1.23(95%%CI:1.00~1.50)]、僵硬[OR=1.54(95%CI:1.34~1.85)]和下肢功能较差[OR=1.17(95%CI):1.11~1.20)]的受试者发生运动恐惧的风险增高。结论 发生AIMSS的乳腺癌患者发生运动恐惧的风险高于未发生AIMSS的患者。患有下肢疼痛、僵硬和功能障碍的患者发生运动恐惧的风险增高。Objective To investigate the association between aromatase inhibitor associated musculoskeletal symptoms(AIMSS) and to exercise phobia in breast cancer patients.Methods A total of 300 breast cancer patients treated in the hospital from April 2017 to July 2019 were included,Exercise phobia was assessed for using the Tampa Scale of Kinesiophobia(TSK).Pain,stiffness and physical function at hips and knees were evaluated to use the Western Ontario and McMaster university Osteoarthritis Index(WOMAC) questionnaire.Disabilities Questionnaire of the Arm and Shoulder and Hand Questionnaire(DASH) will assess the pain in upper limbs and physical function.PA was assessed by international physical activity questionnaire.Descriptive statistics and univariate analysis were performed on all the study variables with using Wilcoxon rank sum or Fishers exact test,and logistic multivariate analysis were performed for variables with P < 0.15.Results Subjects with AIMSS were more likely to develop motor phobia [OR = 2.29(95%CI:1.36-3.86),P=0.002].The hip and knee(WOMAC) and arm,shoulder,and hand(DASH) functional scores were decreased significantly in 139 subjects with AIMSS and 56 with motor phobia(P < 0.05).Subjects reported lower limb pain [OR=1.23(95%CI:1.00~1.50)],stiffness [OR =1.54(95%CI:1.34~1.85)],and poor lower limb function [OR=1.17(95%CI:1.11~1.20)] had an increased risk of kynophobia.Conclusion Breast cancer patients with AIMSS were significantly more likely to have reduce PA than those without AIMSS,and the patients with lower limb pain,stiffness,and dysfunction were at increased risk of motor phobia.

关 键 词：芳香酶 疼痛 僵硬 身体功能 乳腺癌 

分 类 号：R681.1[医药卫生—骨科学]