肺癌脑转移患者神经认知功能分析

被引：5

作者：

甄俊杰 ^{[1
]}

彭章瑞 ^{[2
]}

李少群 ^{[1
]}

赖名耀 ^{[1
]}

凌雪冰 ^{[1
]}

王立超 ^{[1
]}

蔡林波 ^{[1
]}

机构：

[1] 广东三九脑科医院肿瘤综合治疗中心

[2] 广东三九脑科医院心理行为科

来源：

广东医学 | 2019年 / 40卷 / 01期

关键词：

肺癌脑转移; 神经认知功能; 放疗;

D O I：

10.13820/j.cnki.gdyx.20185298

中图分类号：

R734.2 [肺肿瘤];

学科分类号：

100117 [系统生物医学];

摘要：

目的评估肺癌脑转移患者放疗前神经认知功能基线水平,确定导致患者神经认知功能损害的危险因素。方法回顾性分析74例肺癌脑转移患者的临床资料,所有患者均在头部放疗前1～2周进行神经认知功能量表评估。心理测量师根据各项量表得分,评估患者的神经认知功能水平,分为正常、轻度损害、中度损害及重度损害4个等级。应用R软件与EmpowerStats(易侕软件)分析认知评估结果与各临床特征的关系。采用Kappa检验比较体格检查与认知量表评估患者认知功能结果的一致性。对相关的因素作单因素分析及多因素分析。结果 74例患者中,临床体格检查发现认知下降21例(28. 4%),认知正常53例(71. 6%);神经认知量表评估结果显示认知正常6例(8. 1%)、轻度损害26例(35. 1%)、中度损害2例(2. 7%)、重度损害40例(54. 1%)。用Kappa检验比较两种评估方法的一致性,Kappa <0. 4,提示两种评估方法的差异显著。对认知功能损害的相关因素作单因素分析,结果显示可能影响患者神经认知功能损害程度的因素有年龄、KPS评分、GPA评分、RPA分级、转移瘤个数。多因素分析结果表明年龄≥60岁、RPAⅡ级以上是影响认知功能损害程度的独立危险因素。结论肺癌脑转移瘤患者在头部放疗前大多已出现程度不同的神经认知功能损害。年龄≥60岁、RPAⅡ级以上是神经认知功能损害的独立危险因素。

引用

页码：50 / 54

页数：5

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