胃癌患者术前营养相关血液生化指标与PG-SGA评分的相关性研究  

The correlation between nutrition related blood biochemical indexes levels and PG-SGA score in preoperative patients with gastric cancer

作　　者：零春润 叶州 白丽芬[1] 王默进[1] 庄文[1] 

机构地区：[1]四川大学华西医院胃肠外科中心,成都610041

出　　处：《中国普外基础与临床杂志》2017年第8期958-962,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：四川省科技厅科技支撑计划项目(项目编号:2013FZ0091)

摘　　要：目的探讨营养相关血液生化指标水平与患者主观整体评估(patient-generated subjective global assessment,PG-SGA)评分在胃癌患者术前营养评估中的相关性。方法纳入华西医院胃肠外科接受手术治疗的胃癌患者117例作为研究对象,应用PG-SGA营养评估量表进行术前营养状况评估,同时测定空腹静脉血营养相关指标转铁蛋白(TRF)、前白蛋白(PA)、白蛋白(Alb)和血红蛋白(HGB)水平,并将结果进行相关性分析。结果营养不良组(PG-SGA评分≥4分,n=80)患者血清TRF、PA、Alb和HGB水平均低于非营养不良组(PG-SGA评分<4分,n=37,P<0.05);患者术前的TRF、PA、Alb和HGB水平与PG-SGA得分存在负相关关系,相关系数分别为–0.629、–0.545、–0.418和–0.235(均P<0.05);PG-SGA得分≥4分对应的血液TRF、PA、Alb和HGB临界值分别为2.31 g/L、190.50 mg/L、38.65 g/L及100.50 g/L(P<0.05)。结论胃癌患者术前营养不良发生率高。营养不良患者血清TRF、PA、Alb及HGB水平明显下降,且这些指标与PG-SGA得分存在负相关关系。当胃癌患者存在血清TRF≤2.31g/L、PA≤190.50 mg/L、Alb≤38.65g/L或HGB≤100.50 g/L之一时,即可能存在营养不良,应引起高度重视。PG-SGA评分与营养相关血液生化指标联合检测对胃癌患者进行术前营养评估能够提高其准确性,为术前营养干预提供依据。Objective To investigate the correlation between nutrition related blood biochemical indexes levels and Patient-Generated Subjective Global Assessment （PG-SGA） in preoperative nutritional assessment of patients with gastric cancer. Methods One hundred and seventeen gastric cancer patients who underwent surgery were enrolled in this study by the Department of Gastrointestinal Surgery of West China Hospital. Nutritional status of each patient was evaluated by PG-SGA, in the meantime, nutrition related blood biochemical indexes levels such as transferrin （TRF）, prealbumin （PA）, albumin （Alb）, and hemoglobin （HGB） were measured by analysis of fasting venous blood, then take correlation analysis on the result. Results Eighty cases （68.4%） were in malnutrition （PG-SGA score≥4）. The TRF, PA, Alb, and HGB in malnutrition patients were lower than those in non-malnutrition patients （PG-SGA score〈4, n=37, P〈0.05）. The TRF, PA, Alh, and HGB levels of gastric cancer patients had significant negtive correlation with PG-SGA score, the correlation coefficients was -0.629, -0.545, -0.418, and -0.235, respectively （P〈0.05）. When the PG-SGA score was greater than or equal to 4 points, the optimum cutoffvalue for TRF, PA, Alb, and HGB was 2.31 g/L, 190.50 mg/L, 38.65 g/L, and 100.50 g/L, respectively （P〈0.05）. Conclusions The incidence of malnutrition is high in gastric cancer patients preoperatively. The TRF, PA, Alb, and HGB are significantly decreased in the patients with malnutrition, and these indicators has significant negtive correlation with PG-SGA score. The current study indicated that a gastric cancer patient might be in malnutrition when the biochemical levels are less than or equal to TRF 2,31 g/L, PA 190.50 mg/L, Alb 38.65 g/L, HGB 100.50 g/L, and sufficient attention should be paid when any of these occasions appear clinically. The combination of PG-SGA score and nutrition related blood biochemical indexes levels could provide a more accurate assessment of preoperative

关 键 词：胃癌 营养评估 营养相关血液生化指标 

分 类 号：R735.2[医药卫生—肿瘤]