GLIM标准下诊断的营养不良对原发性胃肠道淋巴瘤患者结局的影响  

Effect of malnutrition based on Global Leadership Initiative on Malnutrition criteria on the outcomes of primary gastrointestinal lymphoma patients

作　　者：赵阳阳 卢娟娟[2] 李青芬 黄秀娟[1] 魏小芳 冯友繁[1] 张启科[1] Zhao Yangyang;Lu Juanjuan;Li Qingfen;Huang Xiujuan;Wei Xiaofang;Feng Youfan;Zhang Qike(Hematology Department,Gansu Provincial Hospital,Lanzhou 730000,China;Gastroenterology Department,Gansu Provincial Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院血液科,兰州730000 [2]甘肃省人民医院消化科,兰州730000

出　　处：《中华临床营养杂志》2023年第2期100-105,共6页Chinese Journal of Clinical Nutrition

基　　金：甘肃省人民医院院内科研基金项目(21GSSYC-14);甘肃省科技计划项目(21JR11RA201,22JR5RA660)。

摘　　要：目的:探讨以全球营养领导层诊断营养不良标准(Global leadership initiative on malnutrition,GLIM)诊断的营养不良对原发性胃肠道淋巴瘤(primary gastrointestinal lymphoma,PGIL)患者结局的影响。方法:回顾性分析2014年1月至2022年7月甘肃省人民医院收治的82例PGIL患者的临床资料,经营养风险筛查2002量表进行营养风险筛查后,应用GLIM标准进行营养不良诊断,采用Kaplan-Meier生存曲线和多因素Cox回归分析,探讨GLIM标准下诊断的营养不良对PGIL患者结局的影响。结果:经GLIM标准诊断的28例营养不良患者其体重指数、臂围、腿围和握力等表型特征比非营养不良患者显著性降低(P<0.05)。GLIM标准下营养不良组患者的中位总生存期为10个月,而无营养不良组患者的中位总生存期为41个月,两组患者的生存曲线存在显著性差异。单因素分析显示,年龄、肌肉重量下降、Lugano分期、GLIM标准下营养不良是PGIL患者总生存期的影响因素;多因素分析显示,Lugano分期和GLIM标准下营养不良是影响PGIL患者总生存期的独立危险因素。结论:GLIM标准下营养不良是影响PGIL患者结局的独立危险因素,GLIM标准下营养不良诊断是患者结局评价的一项有效工具。Objective To investigate the impact of malnutrition diagnosed with Global Leadership Initiative on Malnutrition(GLIM)criteria on the outcomes of patients with primary gastrointestinal lymphoma(PGIL).Methods Patients with PGIL admitted into Gansu Provincial People's Hospital from January 2014 to July 2022 were retrospectively enrolled.Nutritional risk screening was conducted using Nutritional Risk Screening 2002(NRS 2002)scale,and malnutrition was diagnosed as per GLIM criteria.Kaplan-Meier survival analysis and multivariate Cox regression analysis were performed to investigate the effect of malnutrition as per GLIM criteria on the outcomes of PGIL patients.Results A total of 82 patients were included.The phenotypic parameters,including body mass index(BMI),arm circumference,leg circumference and grip strength,were at significantly lower levels in the 28 malnourished patients,compared with the other non-malnourished patients.The median overall survival of patients with malnutrition as per GLIM criteria was 10 months,while that of patients without malnutrition was 41 months,showing significant differences between groups.The univariate analysis revealed that age,loss of muscle mass,tumor stage based on Lugano classification and malnutrition as per GLIM criteria were the impacting factors for survival in patients with PGIL.The multivariate analysis further demonstrated that tumor stage based on Lugano classification and malnutrition as per GLIM criteria were the independent impacting factors for survival in patients with PGIL.Conclusion Malnutrition based on GLIM criteria is an independent risk factor for unfavorable outcomes in patients with PGIL and could be utilized as a prognostic indicator.

关 键 词：GLIM标准 营养不良 原发性胃肠道淋巴瘤 结局 

分 类 号：R735[医药卫生—肿瘤]