积极营养干预对晚期伯基特淋巴瘤儿童化疗后营养状况的影响  

Effect of active nutritional intervention on nutritional status of children with advanced Burkitt lymphoma after chemotherapy

作　　者：赵文利[1] 黄鸿眉 闫洁[1] 杨文利[1] 黄爽[2] 段彦龙[2] Zhao Wenli;Huang Hongmei;Yan Jie;Yang Wenli;Huang Shuang;Duan Yanlong(Department of Clinical Nutrition,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing 100045,China;Department of Medical Oncology,Pediatric Oncology Center,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing Key Laboratory of Pediatric Hematology Oncology,Key Laboratory of Major Diseases in Children,Ministry of Education,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院临床营养科,北京100045 [2]国家儿童医学中心,首都医科大学附属北京儿童医院儿童肿瘤中心肿瘤内科,北京市儿童血液肿瘤重点实验室,儿科重大疾病研究教育部重点实验室,北京100045

出　　处：《国际输血及血液学杂志》2024年第6期488-493,共6页International Journal of Blood Transfusion and Hematology

基　　金：白求恩·儿科中青年医生能力提升计划暨儿童临床营养研究专项资助项目(2022E17-B4)。

摘　　要：目的探讨积极营养干预对晚期(Ⅲ~Ⅳ期)伯基特淋巴瘤(BL)患儿化疗后营养状况的影响。方法选择2021年2月至2024年1月首都医科大学附属北京儿童医院肿瘤内科收治的128例初治晚期BL患儿为研究对象,按营养干预方式分为积极营养干预组(n=67,个体化营养支持方案)和常规营养干预组(n=61,标准营养指导)。2组患儿年龄、疾病临床分期等一般情况比较,差异无统计学意义(均为P>0.05)。采用回顾性研究方法,收集2组患儿的化疗前、后营养情况,以及入院次数和住院费用等相关资料。定量资料比较采用独立样本t检验或Mann-Whitney U检验,定性资料比较采用χ^(2)检验。本研究遵循的程序符合首都医科大学附属北京儿童医院伦理委员会制定的标准,经过该伦理委员会批准(批准文号:[2024]-Y-107-D),并与所有患儿监护人签署知情同意书。结果①化疗前2组晚期BL患儿的儿童肿瘤患者营养风险筛查工具(SCAN)评分、体质指数(BMI)、身高别体质量Z评分(WHZ)/年龄别体质量指数Z评分(BAZ)、营养不良患者数、超重/肥胖患者数、脂肪量指数(FMI)、去脂体质量指数(FFMI)和体脂肪率(FMP)分别比较,差异均无统计学意义(均为P>0.05)。②化疗后,积极营养干预组晚期BL患儿SCAN评分<3分患者比例[49.3%(33/67)比31.1%(19/61)]、BMI[(16.4±3.4)kg/m 2比(15.4±2.3)kg/m 2]、FFMI[(12.8±1.7)kg/m 2比(12.2±1.5)kg/m 2]均高于常规营养干预组,并且差异均有统计学意义(χ^(2)=4.34、t=-2.05、t=-2.10,均为P<0.05)。③积极营养干预组晚期BL患儿的非化疗入院次数和住院费用分别为(3.0±1.2)次和(19.1±6.3)万元,低于常规营养干预组的(3.4±1.3)次和(23.2±7.6)万元,并且差异均有统计学意义(t=2.19,P=0.031;t=2.04,P=0.043)。结论积极营养干预可改善晚期BL患儿的营养状况,减少肌肉流失,降低非计划入院次数及医疗费用。Objective To explore the effect of active nutritional intervention on the nutritional status of children with advanced(stageⅢ-Ⅳ)Burkitt lymphoma(BL)after chemotherapy.Methods From February 2021 to January 2024,a total of 128 children with initially treated advanced BL admitted to the Department of Medical Oncology of Beijing Children′s Hospital,Capital Medical University were selected as the research subjects.They were divided into active nutrition intervention group(n=67,individualized nutrition support plan)and conventional nutrition intervention group(n=61,standard nutrition guidance)according to the nutritional intervention method.There were no significant differences in age,clinical stage of disease and other general conditions between two groups(all P>0.05).A retrospective study was conducted to collect data on nutritional status before and after chemotherapy,as well as the number of non-chemotherapy hospitalizations and hospitalization costs of children in both groups.Independent sample t test or Mann-Whitney U test was used for comparison of quantitative data,and chi-square test was used for comparison of qualitative data.The procedures followed in this study were in accordance with the standards established by the Human Trials Committee of Beijing Children′s Hospital Affiliated to Beijing Children′s Hospital,Capital Medical University,and had been approved by the ethics committee(Approval No.[2024]-Y-107-D),and informed consent signed by all children′s guardians.Results①There were no significant differences in nutrition screening tool for childhood cancer(SCAN)score,body mass index(BMI),weight-for-height Z score(WHZ)/weight-for-age Z score(BAZ),number of malnourished patients,number of overweight/obese patients,fat mass index(FMI),fat-free mass index(FFMI)and body fat percentage(FMP)between two groups(all P>0.05).②After chemotherapy,the proportion of patients with SCAN score<3 points[49.3%(33/67)vs 31.1%(19/61)],BMI[(16.4±3.4)kg/m 2 vs(15.4±2.3)kg/m 2],and FFMI[(12.8±1.7)kg/m 2 vs(12.2

关 键 词：伯基特淋巴瘤 营养支持 身体成分 人体质量指数 儿童 

分 类 号：R73[医药卫生—肿瘤]