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中国胶质瘤患者的神经精神症状和炎症标志物:网络分析。

Psychoneurological symptoms and inflammatory markers in patients with glioma in China: a network analysis.

机构信息

School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China.

Department of Neurosurgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.

出版信息

Support Care Cancer. 2023 Jul 3;31(7):435. doi: 10.1007/s00520-023-07873-6.

Abstract

PURPOSE

Anxiety, depression, sleep disorder, fatigue, and pain develop as common psychoneurological symptoms in patients with glioma, and their occurrence and development are potentially related to inflammatory factors. However, this theory has not been proven within the context of glioma. This study aimed to estimate interconnections among psychoneurological symptoms and inflammatory biomarkers by a network analysis.

PATIENTS AND METHODS

We selected 203 patients with stage I-IV glioma from a tertiary hospital in China using convenient sampling method. Patients completed the self-made questionnaires, Hamilton Anxiety Scale-14 (HAMA-14), Hamilton Depression Scale-24 (HAMD-24), Pittsburgh Sleep Quality Index (PSQI), Multidimensional Fatigue Inventory-20 (MFI-20), and pain Numerical Rating Scale (NRS). The plasma inflammatory cytokines were examined. Partial correlation network analysis was performed to illustrate interactions of symptoms and inflammatory biomarkers.

RESULTS

Among the 203 included patients, all psychoneurological symptoms, except for depression and pain, exhibited significant connections with each other. Depression, anxiety, fatigue, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) with higher strength centrality indices were identified as the most central node within the symptom-biomarker network.

CONCLUSIONS

Depression, anxiety, fatigue, IL-6, and TNF-α play a significant role in the symptom-biomarker network in patients with glioma. Medical staff should strengthen the dynamic evaluation of the involved symptoms and inflammatory cytokines and take effective measures to alleviate the burden of symptoms and improve the quality of life of patients.

摘要

目的

焦虑、抑郁、睡眠障碍、疲劳和疼痛是胶质瘤患者常见的神经精神症状,其发生和发展可能与炎症因子有关。然而,这一理论在胶质瘤中尚未得到证实。本研究旨在通过网络分析来评估神经精神症状和炎症生物标志物之间的相互关系。

方法

我们采用便利抽样法,从中国一家三级医院选择了 203 名 I-IV 期胶质瘤患者。患者完成了自拟问卷、汉密尔顿焦虑量表 14 项(HAMA-14)、汉密尔顿抑郁量表 24 项(HAMD-24)、匹兹堡睡眠质量指数(PSQI)、多维疲劳量表 20 项(MFI-20)和疼痛数字评分量表(NRS)。检测了血浆炎症细胞因子。采用偏相关网络分析来阐明症状和炎症生物标志物之间的相互作用。

结果

在 203 名纳入的患者中,除抑郁和疼痛外,所有神经精神症状之间均存在显著的相互关系。抑郁、焦虑、疲劳、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)具有较高的中心性指数,被确定为症状-生物标志物网络中的最中心节点。

结论

抑郁、焦虑、疲劳、IL-6 和 TNF-α在胶质瘤患者的症状-生物标志物网络中起着重要作用。医务人员应加强对相关症状和炎症细胞因子的动态评估,并采取有效措施减轻症状负担,提高患者的生活质量。

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