恶性肿瘤住院患者肌肉减少症的调查及影响因素分析  

Investigation and analysis of influencing factors of sarcopenia in hospitalized patients with malignant tumors

作　　者：张玲玲[1,2] 郑峥[1,3] 何丽 李娜[1,3] 安永辉[1,3] 李增宁 Zhang Lingling;Zheng Zheng;He Li;Li Na;An Yonghui;Li Zengning(Department of Oncology,The First Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei China;Department of Clinical Nutrition,The First Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei China;Key Laboratory of Nutrition and Health of Hebei Province,Shijiazhuang 050031,Hebei China)

机构地区：[1]河北医科大学第一医院肿瘤科,石家庄050031 [2]河北医科大学第一医院临床营养科,石家庄050031 [3]河北省营养与健康重点实验室,石家庄050031

出　　处：《肿瘤代谢与营养电子杂志》2022年第5期645-651,I0004,共8页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：中国保健医学研究会合作项目(HZ202102);2020年政府资助临床医学优秀人才培养项目(LS202002)。

摘　　要：目的调查恶性肿瘤住院患者肌肉减少症的发生情况,分析其相关影响因素,并比较有无肌肉减少症的患者之间人体成分、血清学指标及生活质量的差异,为改善患者预后提供数据。方法收集321例恶性肿瘤住院患者,利用多频生物电阻抗分析仪对患者进行人体成分测量,依据亚洲肌肉减少症工作组(AWGS)诊断标准进行肌肉减少症诊断,并分为肌肉减少症组和无肌肉减少症组;营养状况评估采用患者主观整体评估(PG-SGA),全身炎症反应评价采用改良格拉斯哥预后评分(mGPS),生活质量评估采用欧洲生活质量协作组癌症核心量表(QLQ-C30)。采用单因素及多因素Logistic回归分析影响患者发生肌肉减少症的因素。采用t检验和秩和检验比较两组体成分、血清学指标及生活质量的组间差异。结果本研究共有102例患者诊断为肌肉减少症,发病率为31.78%;结果显示患者在不同PG-SGA、体质指数(BMI)、mGPS分组中肌肉减少症的发病率均有统计学差异(P<0.05),且BMI是影响其发病率的独立因素。肌肉减少症患者各体成分量及血红蛋白、白蛋白、甘油三酯低于无肌肉减少症患者,而细胞外水分比率高于无肌肉减少症患者;在生活质量中功能领域、症状领域评分低于无肌肉减少症患者,便秘、食欲减退评分高于无肌肉减少症患者,差异有统计学意义(P<0.05)。结论恶性肿瘤住院患者肌肉减少症的发生率与PG-SGA、BMI、mGPS有关,其中BMI是影响发生率的独立因素;肌肉减少症导致患者各体成分量降低、营养状况差、全身炎症反应评分高、相位角水平低、生活质量差。Objective To investigate the occurrence of sarcopenia in hospitalized patients with malignant tumor,analyze the related influencing factors,and compare the differences in body composition,serological indicators and quality of life between the sarcopenia group and the non-sarcopenia group,so as to provide clinical data for improving the prognosis of patients.Method A total of 321hospitalized patients with malignant tumor were collected and their body composition was measured by multi-frequency bioelectrical impedance analyzer.Sarcopenia was diagnosed according to the Asian Sarcopenia Working Group(AWGS)diagnostic criteria and divided into sarcopenia group and non-sarcopenia group.Nutritional status was assessed by patient subjective global assessment(PGSGA),systemic inflammatory response was assessed by improved Glasgow outcome score(m GPS),and quality of life was assessed by the European Quality of Life Collaboration Group cancer core scale(QLQ-C30).Univariate and multivariate Logistic regression were used to analyze the factors affecting the occurrence of sarcopenia.T test and rank sum test were used to compare the differences of body composition serological indexes and quality of life between the two groups.0.05 means the difference is statistically significant.Result In this study,102 patients were diagnosed with sarcopenia,with an incidence of 31.78%.The results showed that there were statistically significant differences in the incidence of sarcopenia among different PG-SGA body mass index(BMI)m GPS groups(P<0.05),and BMI was an independent factor affecting the incidence of sarcopenia patients with body weight and hemoglobin albumin triglyceride were significantly lower than those without sarcopenia patients,while extracellular moisture ratio was higher than those without sarcopenia.The scores of functional domains and symptom domains in quality of life were lower than those in patients without sarcopenia,and the scores of constipation and anorexia were higher than those in patients without sarcopenia,with s

关 键 词：恶性肿瘤 肌肉减少症 人体成分 营养状况 全身炎症反应 

分 类 号：R730[医药卫生—肿瘤] R685[医药卫生—临床医学]