BMI联合血液学指标的营养状态评估在晚期消化道肿瘤患者化疗耐受性中的价值分析  

Significance of nutritional status evaluation of BMI combined with hematological indexes in chemotherapy tolerance of patients with advanced digestive tract tumor after operation

作　　者：叶忠伟[1] 吴雪莲[1] 何易[2] YE Zhongwei;WU Xuelian;HE Yi(Department of Cancer Center,Lishui Central Hospital,Lishui,Zhejiang 323000,China;不详)

机构地区：[1]丽水市中心医院肿瘤中心,浙江丽水323000 [2]丽水市中心医院营养科

出　　处：《中华全科医学》2024年第9期1533-1537,共5页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2023KY1355)。

摘　　要：目的晚期消化道肿瘤患者营养状态影响患者化疗的耐受性。因此,准确评估晚期消化道肿瘤患者营养状况,有利于早期识别晚期消化道肿瘤化疗不耐受的高危人群。为此本研究纳入BMI及血液学指标用于营养状态的评估中,并分析其在识别晚期消化道肿瘤患者化疗耐受性中的价值。方法纳入2021年8月—2023年1月在丽水市中心医院接受化疗的255例晚期消化道肿瘤患者,根据患者化疗耐受性将患者分为耐受组和不耐受组,使用logistic回归分析研究晚期消化道肿瘤患者化疗耐受性的影响因素,绘制ROC曲线及列线图分析BMI联合血液学营养指标的营养评估在化疗耐受性预测中的价值。结果255例晚期消化道肿瘤患者中共58例发生化疗不耐受,纳入不耐受组,197例患者化疗耐受,纳入耐受组。Logistic回归分析显示,年龄(OR=1.098)、BMI(OR=0.550)、ALB(OR=0.593)、前白蛋白(PAB,OR=0.885)、转铁蛋白(TRF,OR=0.779)是晚期消化道肿瘤术后患者化疗耐受性的影响因素(P<0.05);调整年龄后,BMI、ALB、PAB、TRF仍是晚期消化道肿瘤患者化疗耐受性的影响因素(P<0.05);联合BMI、ALB、PAB、TRF指标预测晚期消化道肿瘤患者化疗耐受性的C-index为0.952。结论BMI联合血液学营养指标ALB、PAB、TRF可用于预测晚期消化道肿瘤术后患者的化疗耐受性。ObjectiveThe nutritional status of patients with advanced digestive tract tumours has been demonstrated to affect their tolerance to chemotherapy.Consequently,an accurate evaluation of the nutritional status of patients with advanced digestive tract tumours is conducive to the early identification of high-risk groups with chemotherapy intolerance of advanced digestive tract tumours.Accordingly,the evaluation of nutritional status included the measurement of BMI and hematological indices,with a view to analyzing their value in identifying chemotherapy tolerance in patients with advanced digestive tract tumours was analyzed.MethodsA total of 255 patients with advanced digestive tract tumours who received chemotherapy at Lishui Central Hospital from August 2021 to January 2023 were divided into a tolerance group and an intolerance group according to their chemotherapy tolerance.Logistic regression was employed to analyze the factors influencing the chemotherapy tolerance of patients with advanced digestive tract tumours,and the receiver operating characteristic(ROC)was constructed to analyze the value of nutritional evaluation of BMI combined with hematological nutritional indicators in predicting chemotherapy tolerance.ResultsA total of 255 patients with advanced digestive tract tumours were included in the study.Of these,58 patients were intolerant to chemotherapy,while 197 patients were also intolerant to chemotherapy.The results of the logistic regression analysis indicated that age(OR=1.098),BMI(OR=0.550),ALB(OR=0.593),PAB(OR=0.885)and TRF(OR=0.779)were the influencing factors of postoperative chemotherapy tolerance in patients with advanced digestive tract tumours(P<0.05).Following age adjustment,BMI,ALB,PAB and TRF remain significant influencing factors of chemotherapy tolerance in patients with advanced digestive tract tumours(P<0.05).The combined use of BMI,ALB,PAB and TRF yielded a C-index of 0.952 for predicting chemotherapy tolerance in patients with advanced digestive tract tumours.ConclusionThe combina

关 键 词：晚期消化道肿瘤 体重指数 血液学指标 营养状态 化疗耐受性 

分 类 号：R735[医药卫生—肿瘤] R730.53[医药卫生—临床医学]