相位角评估喉癌病人营养状况可行性研究  

A study of the feasibility of using phase angle to assess the nutritional status of patients with laryngeal cancer

作　　者：黄梦玄 曹峻[2] 姜靖滔 马建红 沈红艺 吴嘉珍 HUANG Meng-xuan;CAO Jun;JIANG Jing-tao;MA Jian-hong;SHEN Hong-yi;WU Jia-zhen(School of Public Health,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Department of Nutrition,EYE&ENT Hospital of Fudan University,Shanghai 200031,China)

机构地区：[1]上海中医药大学公共健康学院,上海201203 [2]复旦大学附属眼耳鼻喉科医院营养科,上海200031

出　　处：《肠外与肠内营养》2021年第4期199-203,共5页Parenteral & Enteral Nutrition

摘　　要：目的:探讨相位角(PA)评估喉恶性肿瘤病人营养状况的可行性。方法:收集140例喉癌住院病人,术前使用Inbody S10行人体成分分析、记录PA值,同时进行营养筛查与评估、体格测量与实验室检查。分析PA与营养相关指标的相关性,并以病人主观整体评估(PG-SGA)为营养评价标准,绘制PA的受试者工作特征(ROC)曲线,进而根据截断值分为低PA组与高PA组,计算低PA组营养不良的相对危险度。结果:PA与体质量、BMI、上臂围、上臂肌围、总蛋白、前白蛋白、血红蛋白呈正相关(P<0.05),与年龄、细胞外水分率(ECW/TBW)呈负相关(P<0.05);PA的ROC曲线下面积0.71(P<0.01),诊断为营养不良的PA截断值为5.89,灵敏度0.69,特异度0.68,约登指数0.37;低PA组营养不良的比例(71.2%)明显高于高PA组(34.3%),与高PA组相比,低PA组发生营养不良的相对危险度为2.28(95%CI,1.53~3.41)。结论:相位角与喉癌病人的营养状况密切相关,在喉癌病人营养不良的诊断中具有一定的临床应用价值。Objective:To explore the feasibility of using phase angle(PA)to assess the nutritional status of patients with malignant laryngeal tumor.Methods:140 patients with laryngeal cancer who were hospitalized to receive laryngeal resection were collected.Body composition analysis,nutritional screening and assessment,physical measurements,and laboratory examinations were performed preoperatively and related information were collected.The correlation of PA with various nutritional indicators was analyzed.The Receiver Operating Characteristic(ROC)curve for PA was plotted using Patient-Generated Subjective Global Assessment(PG-SGA)as the criteria for nutritional assessment.Patients were further divided into high PA group and low PA group depending on the cut-off value,and the relative risk of malnutrition in low PA group was assessed.Results:PA was positively correlated with weight,body mass index(BMI),upper arm circumference,upper arm muscle circumference,total protein,prealbumin,and hemoglobin(P<0.05),and negatively correlated with age and extracellular water rate(ECW/TBW)(P<0.05).Using PG-SGA as the criteria for nutritional assessment,the area under the ROC curve of PA was 0.71(P<0.01),the cut-off value of PA for the diagnosis of malnutrition was 5.89,the sensitivity was 0.69,the specificity was 0.68,and the Youden index was 0.37.Patients were divided into high PA group and low PA group by the cut-off value 5.89,and the proportion of patients with malnutrition was significantly higher in low PA group(71.2%)than in high PA group(34.3%).The relative risk of malnutrition in low PA group compared to high PA group was 2.28(95%CI,1.53~3.41).Conclusion:Patients with laryngeal cancer generally have favorable preoperative nutritional status.Phase angle is positively correlated with the nutritional status of patients with laryngeal cancer,and of great clinical potential in helping diagnosing malnutrition in these patients.

关 键 词：相位角 喉恶性肿瘤 营养评估 营养不良 人体成分分析 

分 类 号：R459.3[医药卫生—治疗学] R739.65[医药卫生—临床医学]