乳腺癌患者术后抑郁情绪的危险因素及临床预测模型的建立

目的探讨乳腺癌患者术后发生抑郁的危险因素，并建立预测模型，为临床工作提供参考。 方法选取女性乳腺癌术后患者200例，采用抑郁自评量表和家庭支持自评量表对患者进行评估，并记录其年龄、文化程度、人均月收入、医保类型、婚姻状况、肿瘤分期以及手术方式。通过多因素Logistic回归分析确定乳腺癌患者术后发生抑郁的危险因素，并采用ROC曲线评估临床预测模型的价值。 结果多因素Logistic回归分析显示年龄小、人均月收入低、未婚/离异/丧偶是乳腺癌患者术后发生抑郁的危险因素，而家庭支持程度好、肿瘤分期早则是保护因素。临床预测模型的截断值是-0.475，曲线下面积是0.856（95%CI：0.794~0.919）。 结论以年龄、人均月收入、婚姻状况、家庭支持程度和肿瘤分期为预测因子建立的临床预测模型对乳腺癌患者术后抑郁的发生具有良好的预测价值。

Risk factors of postoperative depression in patients with breast cancer and establishment of clinical predictive model

ObjectiveTo investigate the risk factors of postoperative depression in patients with breast cancer and to establish a predictive model, thereby providing reference for clinical work.MethodsA total of 200 female patients with breast cancer were enrolled in this study. The patients were evaluated by the self-rating depression scale and the family support self-rating scale, and their age, education level, monthly income per capita, type of medical insurance, marital status, tumor stage and mode of operation were recorded. Multivariate Logistic regression analysis was used to determine the risk factors of postoperative depression in patients with breast cancer, and ROC curve was used to evaluate the value of clinical predictive model.ResultsMultivariate Logistic regression analysis showed that young age, low monthly income per capita, being unmarried/ divorced/widowed were risk factors for postoperative depression in patients with breast cancer, while good family support and early tumor stage were protective factors. The cutoff value of the clinical predictive model was -0.475, and the area under curve was 0.856(95%CI：0.794-0.919).ConclusionThe clinical predictive model based on age, monthly income per capita, marital status, family support and tumor stage has good predictive value for postoperative depression in patients with breast cancer.