[1]张 雨,张 敏,姬颖华,等.消化系统恶性肿瘤患者营养风险的相关危险因素[J].新乡医学院学报,2020,37(11):1049-1052.[doi:10.7683/xxyxyxb.2020.11.010]
 ZHANG Yu,ZHANG Min,JI Yinghua,et al.Related risk factors of nutritional risk in patients with digestive system malignant tumor[J].Journal of Xinxiang Medical University,2020,37(11):1049-1052.[doi:10.7683/xxyxyxb.2020.11.010]
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消化系统恶性肿瘤患者营养风险的相关危险因素
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年11
页码:
1049-1052
栏目:
临床研究
出版日期:
2020-11-05

文章信息/Info

Title:
Related risk factors of nutritional risk in patients with digestive system malignant tumor
作者:
张 雨张 敏姬颖华李伟伟杨庆辉张 正路 平
(新乡医学院第一附属医院肿瘤科,河南 新乡 453100)
Author(s):
ZHANG YuZHANG MinJI YinghuaLI WeiweiYANG QinghuiZHANG ZhengLU Ping
(Department of Oncology,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan Province,China)
关键词:
消化系统恶性肿瘤营养风险生存质量炎症反应危险因素
Keywords:
malignant tumor of digestive systemnutritional riskquality of lifeinflammatory reactionrisk factor
分类号:
R735
DOI:
10.7683/xxyxyxb.2020.11.010
文献标志码:
A
摘要:
目的 探讨消化系统恶性肿瘤患者发生营养风险的相关危险因素。方法 选择新乡医学院第一附属医院肿瘤科2017年9月至2019年11月收治的101例消化系统恶性肿瘤患者为研究对象,根据营养风险筛查2002评分量表,将患者分为无营养风险组(n=59)和有营养风险组(n=42)。比较2组患者的生存质量及炎症指标的变化;采用logistic回归分析筛选消化系统恶性肿瘤患者发生营养风险的危险因素,并制作受试者工作特征曲线判断独立危险因素对于消化系统恶性肿瘤患者发生营养风险的检验效能。结果 有营养风险组患者的年龄大于无营养风险组(P<0.05),曾接受放射治疗的比例高于无营养风险组(P<0.05),体质量指数(BMI)、躯体功能、角色功能、社会功能、总体生活质量、卡氏功能状态(KPS)评分低于无营养风险组(P<0.05);2组患者的性别、肿瘤部位、病理类型、临床分期、曾接受化学治疗患者的比例比较差异均无统计学意义(P>0.05)。有营养风险组患者中性粒细胞计数、中性粒细胞百分比、血小板淋巴细胞比(PLR)均高于无营养风险组患者(P<0.05);2组患者白细胞计数比较差异无统计学意义(P>0.05)。躯体功能、BMI、KPS评分、PLR是消化系统恶性肿瘤患者发生营养风险的独立危险因素(P<0.05),且对判断消化系统恶性肿瘤患者存在营养风险均具有较好的检验效能。结论 存在营养风险的消化系统恶性肿瘤患者生存质量明显下降,临床炎症指标明显增高,躯体功能、BMI、KPS评分、PLR可作为判断消化系统恶性肿瘤患者发生营养风险的独立危险因素。
Abstract:
Objective To explore the related risk factors of nutritional risk in patients with digestive system malignant tumor.Methods One hundred and one patients with digestive system malignant tumor in the Department of Oncology,the First Affiliated Hospital of Xinxiang Medical College from September 2017 to November 2019 were selected as the research objects.And they were divided into non-nutritional risk group(n=59)and nutritional risk group(n=42)according to the nutrition risk screening 2002 scores.The quality of life and inflammatory indexes were compared between the two groups.The risk factors of nutritional risk of patients with digestive system malignant tumer were screened by logistic regression,and the receiver operating characteristic curve was made to judge the test efficacy of all risk factors.Results The age of patients in the nutritional risk group was larger than that in the non-nutritional risk group(P<0.05);the proportion of patients who received radiotherapy in the nutritional risk group was higher than that in the non-nutritional risk group(P<0.05);the body mass index (BMI),body function,role function,social function,overall quality of life,Karnofsky performance status(KPS) scores of patients in the nutritional risk group were lower than those in the non-nutritional risk group(P<0.05);there were no significant difference in the sex,tumor location,pathological type,clinical stage and the proportion of patients who had received chemotherapy between the two groups (P>0.05).The neutrophil count,neutrophil percentage and platelet-to-lymphocyte ratio(PLR) of patients in the nutritional risk group were higher than those in the non-nutritional risk group (P<0.05);there was no significant difference in white blood cell count between the two groups (P>0.05).The body function,BMI,KPS scores,and PLR were the independent risk factors of nutritional risk in patients with digestive system malignant tumer (P<0.05);and all of them have good test efficiency.Conclusion The quality of life of patients with digestive system malignant tumor with nutritional risk decreased significantly,and the clinical inflammatory indexes increased significantly.Body function,BMI,KPS scores and PLR can be used as the independent risk factors for nutritional risk in patients with digestive system malignant tumor.

参考文献/References:

[1] 胡文梅,胡文婷,杨文元,等.消化系统肿瘤术后联合营养支持的效果及对Ig和炎症指标的影响[J].甘肃科学学报,2019,31(5):63-67.
[2] CHEN W,ZHENG R,BAADE P D,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.
[3] 孙可欣,郑荣寿,张思维,等.2015年中国分地区恶性肿瘤发病和死亡分析[J].中国肿瘤,2019,28(1):1-11.
[4] 蔡昌豪.消化系肿瘤早知道[J].中华保健医学杂志,2012,14(5):421-422.
[5] MISLANG A R,DI DONATO S,HUBBARD J,et al.Nutritional management of older adults with gastrointestinal cancers-an International Society of Geriatric Oncology (SIOG) review paper[J].J Geriatr Oncol,2018,9(4):382-392.
[6] ZI TARSKA M,KRAWCZYK-LIPIEC J,KRAJ L,et al.Chemotherapy-related toxicity,nutritional status and quality of life in precachectic oncologic patients with,or without,high protein nutritional support.A prospective,randomized study[J].Nutrients,2017,9(10):110-123.
[7] CRUSZ S M,BALKWILL F R.Inflammation and cancer:advances and new agents[J].Nat Rev Clin Oncol,2015,12(10):584-596.
[8] GOMES DE LIMA K V,MAIO R.Nutritional status,systemic inflammation and prognosis of patients with gastrointestinal cancer[J].Nutr Hosp,2012,27(3):707-714.
[9] 陈晓秋,李柱,胡阳春,等.消化道恶性肿瘤患者营养风险、营养状况与炎症因子的相关性及其对临床结局的影响[J].广东医学,2015,36(10):1505-1508.
[10] 顾红柳,沙琦,张敏,等.胃肠肿瘤化疗患者血清IL-6、TNF-α水平与营养状况的关系[J].武警后勤学院学报(医学版),2017,26(8):686-688.
[11] JENS K,HJGAARD R H,OLE H,et al.Nutritional risk screening (NRS 2002):a new method based on an analysis of controlled clinical trials[J].Clinical nutrition (Edinburgh,Scotland),2003,22(3):321-336.
[12] AARONSON N K,AHMEDZAI S,BERGMAN B,et al.The European Organization for Research and Treatment of Cancer QLQ-C30:a quality-of-life instrument for use in international clinical trials in oncology[J].J Natl Cancer Inst,1993,85(5):365-376.
[13] TAFFIN E R L,PAEPE D,CAMPOS M,et al.Evaluation of a modified Karnofsky score to assess physical and psychological wellbeing of cats in a hospital setting[J].J Feline Med Surg,2016,18(11):913-920.
[14] 李燕,程垚,徐斌,等.食管癌患者术前营养风险评估与干预的效果评价[J].中华护理杂志,2015,50(2):166-170.
[15] 王玉萍.消化系统恶性肿瘤术前营养风险与术后并发症的关系[J].浙江实用医学,2019,24(4):277-278.
[16] 罗智鹏,石华伟,薛瑶纯,等.常见恶性肿瘤住院病人营养状态的调查和分析[J].肠外与肠内营养,2016,23(3):162-164,169.
[17] PAN H,CAI S,JI J,et al.The impact of nutritional status,nutritional risk,and nutritional treatment on clinical outcome of 2248 hospitalized cancer patients:a multi-center,prospective cohort study in Chinese teaching hospitals[J].Nutr Cancer,2013,65(1):62-70.
[18] 罗茜,曹伟新,施咏梅.消化系统恶性肿瘤病人营养状况与生活质量评价[J].外科理论与实践,2016,21(1):44-48.
[19] 陈娟,杜成,丁震宇,等.恶性肿瘤患者营养状况及相关影响因素分析[J].现代肿瘤医学,2018,26(1):91-94.
[20] 吴国豪.肿瘤患者的营养不良支持[J].中华普通外科学文献:电子版,2015,9(6):417-420.DOI:10.3877/cma.j.issn.1674-0793.2015.06.001.
[21] 李涛,吕家华,郎锦义,等.恶性肿瘤放疗患者营养治疗专家共识[J].肿瘤代谢与营养电子杂志,2018,5(4):358-365.DOI:10.16689/j.cnki.cn11-9348/r.2018.04.006.
[22] 方雪妮,周天,李泉旺,等.中药对肿瘤微环境各组分的调节作用[J].中华中医药杂志,2018,33(2):631-634.
[23] KRENN-PILKO S,LANGSENLEHNER U,THURNER E M,et al.The elevated preoperative platelet-to-lymphocyte ratio predicts poor prognosis in breast cancer patients[J].Br J Cancer,2014,110(10):2524-2530.
[24] KOUPENOVA M,CLANCY L,CORKREY H A,et al.Circulating platelets as mediators of immunity,inflammation,and thrombosis[J].Circ Res,2018,122(2):337-351.
[25] MANDIC A,CAVAR I,SKORO I,et al.Body composition and inflammation in hemodialysis patients[J].Ther Apher Dial,2017,21(6):556-564.
[26] 张乐,刘凯东,刘铭,等.术后早期免疫增强型肠内营养对胃癌患者免疫功能及炎症反应的影响[J].新乡医学院学报,2019,36(4):389-391,396.

更新日期/Last Update: 2020-11-05