| Background and purpose:Non-small cell lung cancer accounts for 85%to 90%of lung cancer and is the most common cause of cancer death.In recent years,substantial progress has been made in lung cancer screening,diagnosis and evaluation,surgery,radiotherapy,chemotherapy,targeting,immunotherapy and other aspects[1].Although targeted drugs and immunotherapy have progressed by leaps and bounds,the indications for these treatments still include a small number of patients,and most patients with advanced lung cancer will inevitably only be able to chemotherapy.Chemotherapy is still the standard of care for patients diagnosed with advanced non-small cell lung cancer.Therefore chemotherapy still plays an indispensable role in the treatment.Chemotherapy often causes a series of side effects in most cancer patients.These side effects are very challenging for doctors and patients and often have a negative impact on quality of life.For example,chemotherapy-induced nausea,vomiting,and the impact on emotional aspects?anxiety,depression?.Anticipated,acute,and delayed chemotherapy-induced nausea and vomiting lead to increased anxiety and depression,poor compliance with chemotherapy,impaired function,and reduced quality of life for patients.At the same time,anxiety and depression are very common in cancer patients,which will aggravate the experience of nausea and vomiting in chemotherapy patients to some extent.Therefore,we cannot ignore the nausea and vomiting caused by chemotherapy,as well as the psychological factors?anxiety and depression?that significantly affect the function of patients.With in-depth research,it has been found that 5-HT plays an important role in nausea,vomiting,and anxiety and depression.Serotonin,also known as 5-HT,is a neurotransmitter with central and peripheral functions,including regulation of mood,appetite,hemodynamics,gastrointestinal sensation,secretion and movement.Intestinal chromaffin cells in the gastrointestinal mucosa are specialized enteroendocrine cells that synthesize and secrete 90%-95%of systemic 5-HT[2].The remaining 5-HT pool is mainly synthesized by 5-HTergic neurons in the central nervous system.Islet,breast and adipose tissue are produced in smaller amounts[3].The purpose of this study is to explore the relationship between nausea,vomiting,anxiety and depression in patients with non-small cell lung cancer before and after initial chemotherapy,and the relationship between 5-HT levels in patients with different degrees of nausea,vomiting,anxiety and depression before and after chemotherapy.Method:Non-small cell lung cancer patients who received to the Department of oncology,The Second Hospital of Dalian Medical University from 2018.9 to 2019.1 were collected.All patients were confirmed by histopathology.All patients received primary chemotherapy.The chemotherapy regimen was platinum-containing dual drugs,and the antiemetics contained 5-HT receptor antagonist.1.5ml of liver biochemistry before and after chemotherapy was collected from the clinical laboratory of our hospital and stored in a refrigerator at–20?in a sterile closed EP tube.The serum 5-HT level of patients before and after chemotherapy was measured by ELISA in ng/ml.To explore the changes of nausea,vomiting,anxiety and depression before and after chemotherapy.SPSS19.0 software was used for statistical analysis,p<0.05 believed that the difference was statistically significant,and T test was used.All indexes were expressed by mean standard deviation?`x±s?.Logistic regression analysis and one-way analysis of variance were used to analyze the forward variance homogeneity test and normal test.Result:1.A total of 26 patients were enrolled in the group.Patients within 24 hours before chemotherapy and within 48-72 hours after chemotherapy were graded for nausea and vomiting according to WHO standards.Before chemotherapy patients with different degrees of nausea and vomiting were divided into 0-grade nausea and vomiting group;Grade I nausea and vomiting group;respectively,77%;23%.After chemotherapy seven patients?27%?suffered from grade 0 nausea and vomiting.There were 4 patients in grade I nausea and vomiting group,accounting for 15%.There were 7 patients in grade II nausea and vomiting group,accounting for 27%.There were 8 patients in grade III nausea and vomiting group,accounting for 31%.There were 0 patients in grade IV nausea and vomiting group.2.SAS?Self-Rating Anxiety Scale?compiled by Zung was used to evaluate the anxiety level of the study subjects before and after chemotherapy.The scores of 20 items were added to obtain the total rough score,and the standard score was equal to the integer part after the total rough score*1.25.The normal upper limit of SAS standard score is 50 points.Those with more than 50 points are considered as SAS group.SDS?Self-rating depression scale?compiled by Zung was used to evaluate the depression degree of the subjects before and after chemotherapy.Add up the scores of20 items to obtain the total rough score,and the standard score is equal to the integral part after the total rough score*1.25.The normal upper limit of SDS standard score is53.Those with more than 53 points are taken as SDS group.Before and after chemotherapy,the nausea and vomiting groups with different degrees were scored with SAS and SDS scales.The SAS and SDS values of patients with nausea before chemotherapy were higher than those of patients without nausea,and the difference was statistically significant?P<0.05?.There was no statistical significance in SAS and SDS values of patients with grade 0,grade I,grade II and grade III nausea and vomiting after chemotherapy?p>0.05?.3.Binary linear logistic regression analysis was conducted with nausea and vomiting before chemotherapy as dependent variables and age,sex,anxiety and depression as independent variables.The results are shown in Table 4.The results showed that anxiety was positively correlated with nausea before chemotherapy ?p<0.05?.That is,anxiety is a risk factor for nausea before chemotherapy.However,there was no correlation between age,sex and depression?p>0.05?.4.Taking post-chemotherapy nausea and vomiting as dependent variables and age,sex,anxiety,depression and pre-chemotherapy nausea as independent variables, multivariate logistic regression analysis was conducted.The results showed that age,sex,anxiety,depression and pre-chemotherapy nausea were not related to post-chemotherapy nausea and vomiting?p>0.05?.5.The changes of serum 5-HT before and after chemotherapy in SAS group,SDS group,normal group?no SAS and no SDS?,grade I,II and III nausea and vomiting group were calculated by paired sample t test respectively,with no statistical significance?p>0.05?.6.The serum 5-HT level of patients with different degrees of nausea and vomiting after chemotherapy was analyzed by one-way ANOVA.The serotonin level of patients with grade II nausea and vomiting was higher than that of patients with grade I nausea and vomiting,and the difference was statistically significant?p<0.05?.Serotonin levels in patients with grade III nausea and vomiting were higher than those in patients with grade II nausea and vomiting,with statistically significant difference?p<0.05?.Conclusion:1.Anxiety is a risk factor for nausea before chemotherapy;2.Anxiety and depression symptoms of patients with nausea before chemotherapy are worse than those of patients without nausea;3.The level of serum 5-HT after chemotherapy is positively correlated with nausea and vomiting of different degrees;... |
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