目的 探讨炎症因子及心理行为症状对胶质瘤患者疲劳的影响，为护理干预方案的制订提供理论依据。 方法 采用便利抽样法选取济南市某三级甲等医院收治的胶质瘤患者203例为研究对象，采用一般资料调查表、汉密顿焦虑量表17项、匹兹堡睡眠质量指数量表、多维疲劳量表20项和疼痛数字评分量表对其进行调查，同时检测患者血浆炎症因子表达水平。 结果 胶质瘤患者疲劳得分为（67.65±16.51）分，其影响因素包括年龄、卡氏功能状态（karnofsky performance status，KPS）评分、焦虑、睡眠障碍、疼痛以及白细胞介素-6（interleukin-6，IL-6）和肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）表达水平（P＜0.05）。炎症因子IL-6和TNF-α表达水平升高对疲劳有显著预测作用，焦虑、睡眠障碍和疼痛在炎症因子和疲劳之间起中介作用。 结论 医护人员应注意观察胶质瘤患者炎症因子水平变化，采取措施缓解胶质瘤患者焦虑、睡眠障碍和疼痛症状，从而降低患者疲劳水平。

Objective To investigate the effects of inflammatory cytokines and psychobehavioral symptoms on fatigue of patients with glioma and to provide theoretical references for formulating targeted nursing interventions. Methods By convenience sampling method,203 patients with glioma from a tertiary hospital in Jinan were selected and investigated by the general information questionnaire,Hamilton Anxiety Scale-17,Pittsburgh Sleep Quality Index Scale,Multidimensional Fatigue Inventory-20 and Pain Digital Scale,while the plasma inflammatory cytokines were detected. Results The fatigue score of glioma patients was (67.65±16.51),and the influencing factors included age,karnofsky performance status score,anxiety,sleep disturbance,pain,and interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α) levels (all P＜0.05).Elevated levels of IL-6 and TNF-α had significant predictive effects on fatigue.Anxiety,sleep disturbance,and pain partially mediated the relationship between inflammatory cytokines and fatigue. Conclusions Medical staff should pay attention to the levels of inflammatory cytokines of patients with glioma and alleviate their anxiety,sleep disturbance and pain,thus reducing fatigue levels.

R473.73

山东省重点研发计划项目(2017GSF218028)