基于生物电阻抗法分析头颈部肿瘤放疗患者机体液体分布与发生放射性口腔黏膜炎相关性的临床研究  

Clinical study on the correlation between body fluid distribution and radiation oral mucositis in patients with head and neck cancer undergoing radiotherapy based on bioelectrical impedance analysis

作　　者：刘婕 赵迪 赵悦欣 鹿红 卞新禹 王培 Liu Jie;Zhao Di;Zhao Yuexin;Lu Hong;Bian Xinyu;Wang Pei(Department of Radiotherapy,Jiangsu Province Hospital of Chinese Medicine,Affliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China;Department of Geriatrics,Taikang Xianlin Drum Tower Hospital,Nanjing 210000,China)

机构地区：[1]南京中医药大学附属医院放疗科,江苏南京210029 [2]泰康仙林鼓楼医院,江苏南京210000

出　　处：《肿瘤代谢与营养电子杂志》2024年第6期834-839,共6页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：江苏省中医药科技发展计划项目(YB2020009)。

摘　　要：目的通过生物电阻抗法(BIA),观察头颈部肿瘤放疗患者放疗期间机体液体分布,包括细胞内水分(ICW)、细胞外水分(ECW)、身体总水分(TBW)、ECW/ICW(%)、ECW/TBW(%)变化,同时通过观察放疗期间口腔黏膜炎(ROM)发生时间、程度,分析液体分布和ROM发生及程度的相关性。方法前瞻性纳入2022年9月至2024年3月在江苏省中医院放疗科行放疗的头颈部肿瘤患者共60例,分别在放疗前,放疗第2周、4周、6周及放疗结束当天测定并记录ICW、ECW、TBW、ECW/ICW(%)、ECW/TBW(%)液体分布指标变化。观察放疗期间患者口腔黏膜炎发生时间及严重程度(RTOG放射性损伤分级标准),探讨其中的相关性。结果在放疗第4周,ICW、ECW、TBW值随ROM程度而发生差异。发生3级及以上的ROM患者与发生2级及以下的ROM患者相比,ICW值明显降低(P<0.05),ECW、ECW/ICW(%)、ECW/TBW(%)值均增高,差异有统计学意义(P<0.05)。而在其他时间段的观察中,均未发现患者机体液体分布和ROM发生的相关性。结论头颈部肿瘤患者放疗期间机体液体分布与放射性口腔黏膜炎的发生及程度明显相关。基于BIA测定的人体液体分布特点,或许可以作为放射性口腔黏膜炎的一个潜在的预测指标,这对于筛选具有较高放射性口腔黏膜炎发生风险的患者,并在症状发生前提前干预,具有巨大的临床意义。Objective Bioelectrical impedance analysis(BIA)was used to observe the fluid distribution of patients with head and neck cancer who were undergoing radiotherapy,including intracellular water,extracellular water,total body water,ECW/ICw(%),ECW/TBW(%)changes.At the same time,by observing the occurrence time and degree of radiation oral mucositis(ROM)during radiotherapy,the correlation between the fluid distribution and the occurrence and degree of ROM was analyzed.Method A total of 60 patients with head and neck caner who were undergoing radiotherapy in the Radiotherapy Department of Jiangsu Province Hospital of Chinese Medicine from September 2022 to March 2024 were prospectively included.fluid distribution indicators such as ICW,ECW,TBW,ECW/ICW(%)and ECW/TBW(%)were collected and recorded before,at the 2nd,4th and 6th week and finished day of radiotherapy,respectively.To observe the occurrence time and severity of oral mucositis during radiotherapy(RTOG radiation damage grading standard)and explore the correlation between them.Result The values of ICW,ECW and TBW varied with the degree of ROM at the 4th week of radiotherapy.ICW values in patients with OM grade 3 or higher were significantly lower than those with OM grade 2 or lower(P<0.05),while ECW,ECW/ICW(%)and ECW/TBW(%)values were increased significantly(P<0.05).No correlations were found between fluid distribution and ROM occurrence in other time.Conclusion The fluid distribution of patients with head and neck cancer during radiotherapy was significantly related to the occurrence and degree of radiation oral mucositis.The characteristics of human fluid distribution based on BIA measurement may be used as a potential predictor of radiation-induced oral mucositis,which has great clinical significance for screening patients with high risk of ROM and prior intervention before symptoms occur.

关 键 词：头颈部肿瘤 放射性口腔黏膜炎 生物电阻抗法 液体分布 细胞内水分 细胞外水分 身体总水分 

分 类 号：R73[医药卫生—肿瘤]