住院肿瘤患者去脂肪组织测定及影响因素分析

Analysis of free fat mass measurement and related influencing factors in hospitalized patients with malignant tumor

目的测量住院肿瘤患者的去脂肪组织体质量(FFM)并分析其影响因素。方法以107例肿瘤内科住院患者为研究对象,其中上消化道肿瘤31例,下消化道肿瘤41例,肺癌14例,其他肿瘤21例。采集患者的一般资料(性别、年龄、诊断、病程、临床分期、化学治疗(化疗)次数、肿瘤手术史、慢性疾病史等)和营养相关指标(白蛋白、前白蛋白和体质量指数);应用生物电阻抗(BIA)方法评估肿瘤患者的FFM和基础代谢率(BMR);应用24 h膳食回顾法评估患者的膳食摄入情况。结果在107例肿瘤患者中,总营养不良发生率为36.4%。上消化道肿瘤、病程>1年的患者营养不良发生率较高;蛋白质摄入充足(≥75%日推荐量)的患者营养不良发生率较低。能量和蛋白质的摄入与FFM呈正相关。男性肿瘤患者中,随着化疗次数的增加,FFM和校正后的BMR明显降低(P<0.05);而女性患者中,仅非消化道肿瘤患者校正后的BMR显著高于消化道肿瘤患者(P<0.05),其余指标的差异均无统计学意义(P>0.05)。结论肿瘤患者的营养不良发生率较高,蛋白质摄入充足可改善患者的营养状况,化学治疗次数多可降低男性肿瘤患者的FFM和校正后的BMR。

Objective To measure the free fat mass （FFM） of hospitalized patients with malignant tumors and to analyze its influence factors. Methods The study selected 107 hospitalized patients from the Department of Medical Oncology. Among them, 31 were uppergastrointestinal tumors; 41 lower gastrointestinal tumors, 14 lung cancers; and 21 other types of tumors. General information （ gender, age, diagnosis, disease duration, clinical stage, number of chemotherapy, history of cancer surgeries, history of chronic diseases, etc. ） and relevant nutritional indexes （albumin, pre-albumin, and body mass index） of padents were collected. The FFM and basal metabolic rate （BMR） were evaluated by the bioelectrical impedance （BIA） method. The dietary energy and protein intake were evaluated based on the 24-hour dietary recalls. Results Among 107 patients, total incidence of malnutrition was 36.4%. The incidence of malnutrition of patients with upper gastrointestinal tumors and longer duration of disease （ 〉1 year） was high, while the incidence of malnutrition of patients with adequate protein intake （ ≥ 75% of the recommended intake per day） was low. Energy and protein intake was positively correlated with FFM. FFM and corrected BMR of male patients decreased significandy with the increase of the number of chemotherapy （ P 〈 0.05）. Only the corrected BMR of female patients with nongastraintestinal tumors was significantly higher than that of patients with gastraintestinal tumors （P〈0.05）. The differences of other indexes were not statistically significant （P 〉 0.05 ）. Conclusion The incidence of malnutrition of patients with tumors was high. Adequate protein intake can improve the nutritional status.FFM and corrected BMR of male patients with malignant tumors decrease with the increase of the number of chemotherapy.