首页|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

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

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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.
Objective The 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 ad-vanced 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.Methods A total of 255 patients with advanced digestive tract tumours who re-ceived 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 in-fluencing the chemotherapy tolerance of patients with advanced digestive tract tumours,and the receiver operating charac-teristic(ROC)was constructed to analyze the value of nutritional evaluation of BMI combined with hematological nutri-tional indicators in predicting chemotherapy tolerance.Results A 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.Conclusion The combination of BMI with he-matological nutritional indexes ALB,PAB and TRF can be employed to predict the chemotherapy tolerance of patients with advanced digestive tract tumours following surgical intervention.

Advanced digestive tract tumorBody mass indexHematology indexNutritional statusChemotherapy tol-erance

叶忠伟、吴雪莲、何易

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丽水市中心医院肿瘤中心,浙江丽水 323000

丽水市中心医院营养科

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

浙江省医药卫生科技计划项目

2023KY1355

2024

中华全科医学
中华预防医学会,安徽省全科医学会

中华全科医学

CSTPCD
影响因子:1.688
ISSN:1674-4152
年,卷(期):2024.22(9)