2026 年第 5 期 第 21 卷

年轻首发乳腺癌患者完成全程用药的影响因素分析

Analysis of influencing factors for completion of full-course medication in young patients with first-episode breast cancer

作者：肖苗1王清1张妹2毕铨3耿桂萍4

英文作者：Xiao Miao1 Wang Qing1 Zhang Mei2 Bi Quan3 Geng Guiping4

单位：1南京医科大学第一附属医院乳腺五病区，南京210000；2南京医科大学第一附属医院骨科四病区，南京210000；3南京医科大学第一附属医院心脏大血管外科四病区，南京210000；4南京医科大学第一附属医院乳腺四病区，南京210000

英文单位：1Breast Fifth Ward the First Affiliated Hospital with Nanjing Medical University Nanjing 210000 China; 2Fourth Ward Department of Orthopedics the First Affiliated Hospital with Nanjing Medical University Nanjing 210000 China; 3Fourth Ward Department of Cardiovascular and Vascular Surgery the First Affiliated Hospital with Nanjing Medical University Nanjing 210000 China; 4Breast Fourth Ward the First Affiliated Hospital with Nanjing Medical University Nanjing 210000 China

关键词：乳腺癌；全程用药；影响因素；社会支持

英文关键词：Breastcancer;Full-coursemedication;Influencingfactors;Socialsupport

• 摘要：

• 目的 探讨年轻首发乳腺癌患者完成全程用药的影响因素。方法 选取2021年1月至2024年6月在南京医科大学第一附属医院治疗的347例年轻首发乳腺癌患者作为研究对象。收集入组患者的临床信息，调查疾病认知和社会支持度，并根据患者是否完成全程用药分为完成全程用药组和未完成全程用药组。采用单因素分析和Logistic回归模型分析年轻首发乳腺癌患者完成全程用药的影响因素。结果 347例年轻首发乳腺癌患者中，完成全程用药组243例，占比70.0%；未完成全程用药组104例，占比30.0%。单因素分析结果显示，年轻首发乳腺癌患者完成全程用药与年龄、生育情况、病理类型、分子分型、文化程度无关（均P＞0.05），而与婚姻状况、临床分期、家庭月收入、疾病认知、社会支持情况、用药时长、不良反应、治疗后结婚/生育意愿有关（均P＜0.05）。经Logistic回归模型分析结果显示，婚姻状况为离异或丧偶（比值比=1.923，95%置信区间：1.165～3.174，P=0.011）、家庭月收入＜5 000元（比值比=2.582，95%置信区间：1.428～4.669，P=0.002）、有不良反应（比值比=2.761,95%置信区间：1.378～5.532，P=0.004）、治疗后无结婚/生育意愿（比值比=1.528，95%置信区间：1.009～2.314，P=0.045）是年轻首发乳腺癌患者完成全程用药的危险因素；疾病认知好（比值比=0.403，95%置信区间：0.227～0.715，P=0.002）、社会支持高（比值比=0.531，95%置信区间：0.368～0.766，P=0.001）是年轻首发乳腺癌患者完成全程用药的保护因素。结论 婚姻状况、家庭月收入、不良反应、治疗后结婚/生育意愿、疾病认知及社会支持是影响年轻首发乳腺癌患者完成全程用药的关键因素，临床应当制定针对性干预策略，以提高患者全程用药完成率，改善患者预后。

• Objective To explore the influencing factors for completion of full-course medication in young patients with first-episode breast cancer. Methods A total of 347 young patients with first-episode breast cancer treated at the First Affiliated Hospital with Nanjing Medical University from January 2021 to June 2024 were enrolled. Clinical data, disease cognition and social support were collected. Patients were divided into full-course medication completion group and non-completion group. Univariate analysis and Logistic regression were used to analyze influencing factors. Results Among 347 young patients with first-episode breast cancer, 243 cases (70.0%) were in the full-course medication completion group, and 104 cases (30.0%) were in the non-completion group. Univariate analysis showed that completion of full-course medication was not associated with age, fertility status, pathological type, molecular subtype, or educational level (all P>0.05), but was associated with marital status, clinical stage, monthly family income, disease cognition, social support, medication duration, adverse reactions, and post-treatment marriage/fertility intention (all P<0.05). Logistic regression analysis revealed that divorced or widowed marital status ［odds ratio(OR)=1.923, 95% confidence interval(CI): 1.165-3.174, P=0.011］, monthly family income <5 000 yuan (OR=2.582, 95%CI: 1.428-4.669, P=0.002), presence of adverse reactions (OR=2.761, 95%CI: 1.378-5.532, P=0.004), and no post-treatment marriage/fertility intention (OR=1.528, 95%CI: 1.009-2.314, P=0.045) were risk factors for non-completion of full-course medication. Good disease cognition (OR=0.403, 95%CI: 0.227-0.715, P=0.002) and high social support (OR=0.531, 95%CI: 0.368-0.766, P=0.001) were protective factors for completion of full-course medication. Conclusion Marital status, family income, adverse reactions, post-treatment marriage/fertility intention, disease cognition and social support are key factors affecting full-course medication completion. Targeted interventions should be adopted to improve adherence and prognosis.