围放疗期全程营养管理在腹部肿瘤领域的应用及对营养现状、T细胞亚群、KPS评分的影响  

Application of whole-course nutritional management in the peri-radiation period and its effects on the nutritional status,T cell subsets and KPS score of the patients with abdominal tumors

作　　者：朱琪伟[1] 王向前[1] 杨磊[2] 杨燕光 丁华[1] 金华[3] ZHU Qi-wei;WANG Xiang-qian;YANG Lei;YANG Yan-guang;DING Hua;JIN Hua(Department of Radiotherapy,Cancer Hospital of Nantong University,Nantong,226361,Jiangsu,China;Department of Nutrition,Cancer Hospital of Nantong University,Nantong,226361,Jiangsu,China;Clinical Research Center of Precision Medicine,Cancer Hospital of Nantong University,Nantong,226361,Jiangsu,China)

机构地区：[1]南通大学附属肿瘤医院放疗科,江苏南通226361 [2]南通大学附属肿瘤医院营养科,江苏南通226361 [3]南通大学附属肿瘤医院精准医学临床研究中心,江苏南通226361

出　　处：《肠外与肠内营养》2021年第4期211-215,共5页Parenteral & Enteral Nutrition

基　　金：南通市市级科技项目(MB2019021)。

摘　　要：目的:探讨围放疗期全程营养管理在腹部肿瘤领域的应用及对营养现状、T细胞亚群、Karnofsky功能状态(KPS)评分的影响。方法:选取2019年1月至2020年7月本院收治的152例腹部肿瘤放疗病人进行前瞻性研究,随机数字表法分为对照组、观察组,各76例。对照组给予常规营养指导,观察组在此基础上给予围放疗期全程营养管理。比较两组营养现状[血红蛋白(Hb)、血清白蛋白(Alb)、前白蛋白(PAB)]、细胞免疫功能(CD4^(+)、CD4^(+)/CD8^(+)、总B淋巴细胞、NK细胞、总T淋巴细胞)、KPS评分、患者主观整体评估(PG-SGA)评分、放疗毒副反应。结果:观察组干预后Hb、Alb、PAB高于对照组(P<0.05)。与对照组比较,观察组干预后CD4^(+)、CD4^(+)/CD8^(+)、总B淋巴细胞、NK细胞、总T淋巴细胞更高(P<0.05)。观察组干预后KPS、PG-SGA评分优于对照组(P<0.05)。观察组放疗毒副反应发生率11.84%低于对照组38.16%(P<0.05)。结论:全程营养管理可有效减轻放疗对腹部肿瘤细胞免疫功能的影响,从而调节营养状态,延缓营养不良进程,减少毒副反应发生。Objective:To investigate the application of whole-course nutritional management during the periradiation therapy field of abdominal tumors and its influences on nutritional status,T cell subsets,and Karnofsky performance status(KPS)score of the patients.Methods:From January 2019 to July 2020,152 patients with abdominal tumors who received radiotherapy in our hospital were prospectively recruited in this study.The patients were randomly divided into the control and observation groups(n=76 each group).The control group was treated with routine nutritional guidance,and the observation group was given with whole-course nutritional management during the peri-radiation period.The nutritional status,cellular immune function,KPS scores,patient-generated subjective global assessment(PG-SGA)score,and toxic side-effects of radiotherapy were evaluated in the patients.Results:The serum levels of hemoglobin(Hb),serum albumin(Alb),prealbumin(PAB)after radiotherapy were higher in the observation group than in the control group(P<0.05).Compared with the control group,the percentage of CD4^(+)T cells,CD4^(+)/CD8^(+) ratios,and the counts in total B lymphocytes,NK cells,and total T lymphocytes were also higher in the observation group after radiotherapy(P<0.05).The KPS and PG-SGA scores in the observation group after intervention were better than in the control group(P<0.05).The prevalence of post-radiotherapy toxic side-effects was much lower in the observation group(11.84%)than in the control group(38.16%)(P<0.05).Conclusion:The whole-course nutrition management could alleviate the side-effects of radiotherapy on the patients with abdominal tumor,possibly through improving the nutritional status and cellular immune function.

关 键 词：放疗 全程营养管理 腹部肿瘤 营养现状 T细胞亚群 Karnofsky功能状态 

分 类 号：R459.3[医药卫生—治疗学]