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目的乳腺癌患者常伴有不同程度的抑郁症,影响患者的生存和生活质量。本研究旨在分析晚期乳腺癌患者抑郁的发生率以及相关因素,探讨抗抑郁药物氟西汀治疗晚期乳腺癌患者抑郁的临床效果。方法选取辽宁省肿瘤医院收治的晚期乳腺癌患者161例作为研究对象,采用抑郁患者自评量表(PHQ-9)进行基线抑郁水平调研,结合临床病理因素分析抑郁相关因素。将基线调研中的重度抑郁患者随机分为氟西汀组(n=21)和空白对照组(n=20),氟西汀组给予氟西汀20mg/d,连用6个月;对照组仅给予安慰剂。测定治疗后2、6和12个月的PHQ-9值。结果晚期乳腺癌患者在基线PHQ-9评估中抑郁的发生率为59.6%(96/161),重度抑郁患者发生率为25.5%,占总抑郁患者的42.7%(41/96)。重度抑郁患者与非抑郁患者相比,在月经状态、ER、PR和HER2表达以及DFS方面差异均有统计学意义,均P值<0.05。氟西汀组PHQ-9评分在治疗后2、6和12个月均显著低于对照组,差异均有统计学意义,均P值<0.05。结论月经状态、ER、PR和HER2表达以及DFS是晚期乳腺癌伴发抑郁的影响因素,氟西汀可显著改善乳腺癌患者伴发的抑郁状况。
The purpose of breast cancer patients are often accompanied by varying degrees of depression, affecting the patient’s survival and quality of life. The purpose of this study was to analyze the incidence of depression in patients with advanced breast cancer and related factors, and to explore the clinical effect of antidepressant fluoxetine in the treatment of patients with advanced breast cancer. Methods A total of 161 patients with advanced breast cancer admitted to Cancer Hospital of Liaoning Province were enrolled in this study. The baseline depression level was assessed by Self-rating Depression Scale (PHQ-9), and the factors associated with depression were analyzed by clinicopathological factors. Patients with major depression in the baseline study were randomized to fluoxetine (n = 21) and blank control (n = 20), and fluoxetine was given to fluoxetine 20 mg daily for 6 months. Give placebo. The PHQ-9 values at 2, 6 and 12 months after treatment were determined. Results The incidence of depression was 59.6% (96/161) in patients with advanced breast cancer and 25.5% in patients with major depression, accounting for 42.7% (41/96) of patients with total depression. Compared with non-depressed patients, there were significant differences in the expression of ER, PR and HER2 and DFS in patients with major depression in menstruation, both P <0.05. Fluoxetine group PHQ-9 score in 2, 6 and 12 months after treatment were significantly lower than the control group, the differences were statistically significant, P value <0.05. Conclusions Menstrual status, ER, PR, HER2 expression and DFS are the influencing factors of advanced breast cancer with depression. Fluoxetine can significantly improve the depression status of patients with breast cancer.