鼻咽癌放疗后患者智能精神状态及其影响因素研究

目的 分析鼻咽癌放疗后患者智能精神状态及其影响因素。方法 选择2010年4月～2011年4月浙江省湖州市中心医院收治的鼻咽癌患者100例为研究对象，所有患者均采用前七野方案进行放射治疗，平均总剂量69．04Gy。治疗后对所有患者均进行简易智能精神状态检查量表（MMSE）、生存质量测定简式量表（WHOQOL—BREF）评分，并对影响患者生活质量的各相关因素进行多因素分析。结果 治疗后，MMSE及WHOQOL—BREF评分[（38．15±9．24）、（3．87±0．55）分]均高于治疗前[（23．56±5．60）、（2．05±0．32）分1，差异有统计学意义（t=10．236、14．247，均P〈0．05）；不同年龄（≥60、〈60岁）、营养状况、有无吸烟史、不同口腔pH均值（≥7、〈7）患者间MMSE评分比较，差异均有统计学意义（均P〈0．05），而在不同性别患者间MMSE评分比较，差异无统计学意义（P〉0．05）。Logistic回归分析显示，年龄≥60岁、BMI≤18．5kg／m^2、吸烟史、口腔pH均值〈7是影响鼻咽癌患者生活质量的主要因素（OR=3．250、3．445、4．662、3．051，均P〈0．05）。结论 影响鼻咽癌调强放疗患者生存质量的高危因素主要有年龄、营养差、吸烟、口腔长期酸性环境，应结合病情及身体状况制订个体化治疗方案。

Study of the intelligent mental state and its influencing factors of patients with nasopharyngeal carcinoma after radiotherapy

Objective To analyze intelligent mental state and its influencing factors of patients with nasopharyngeal carcinoma after radiotherapy. Methods 100 patients with nasopharyngeal carcinoma radiotherapy treatment in Center Hospital of Huzhou City from April 2010 to April 2011 were selected as study objects. All the patients were given the first seven wild scheme for the radiation treatment, and the average total dose were 69.04 Gy. All patients were given the mini-mental state examination （MMSE） and WHOQOL-BREF scoring after the treatment, the investigation of quality of life scale, and the factors affecting the quality of life of patients were analyzed by multiple factor analysis. Resuits MMSE and WHOQOL-BREF of patients after treatment [（38.15±9.24）, （3.87±0.55） scores] were higher than those before treatment [（23.56±5.60）, （2.05±0.32） scores], the differences were statistically significant （t=10.236, 14.247; all P 〈 0.05）; MMSE score between different age（≥ 60, 〈 60 years）, different nutriture, smoking history, oral pH mean value （≥7, 〈7） were statistically significant differences （all P 〈 0.05）, but the MMSE score in different gender had no statistically significant different （P 〉 0.05）. Logistic regression analysis results showed that age ≥ 60 years, BMI ≤ 18.5 kg/m^2, smoking history, oral pH mean value 〈7 were the main factors influencing the nasopharyngeal carcinoma patients quality of life （OR=3.250, 3.445, 4.662, 3.051, all P 〈 0.05）. Conclusion The risk factors which affect the survival quality of patients with nasopharyngeal carcinoma intensity-modulated radiation therapy were age, poor nutriture, smoking, oral acid environment for a long time, the individualized treatment plan should combine with illness and physical condition.