生物电阻抗分析在胃癌患者放疗期间营养评估中的应用

Validity of bioelectrical impedance analysis to assess nutritional status in patients with gastric cancer during radiotherapy

目的:本研究探讨进展期胃癌患者放疗期间的人体成分变化及其与营养风险筛查评分值(nutrition risk screen 2002,NRS-2002)之间的相关性.方法:采用前瞻性的方法,以2013-06/2014-06在复旦大学附属肿瘤医院放疗科40例胃癌患者作为研究对象.采用生物电阻抗方法分析患者放疗期间人体成分的变化,同时进行营养风险筛查及评估.结果:放疗期间随着观察时间的变化,体质量(current weight,CW)、体质量指数(body m a s s i n d e x,B M I)、体质量丢失(w e i g h t loss)、脂肪组织指数(fat mass index,FMI)、去脂组织指数(fat-free mass index,FFMI)及体细胞量(body cell mass,BCM)差异均有统计学意义(P<0.05),骨骼肌量(skeletal muscle mass,SM)及相位角(phase angle,PA)差异均无统计学意义(P>0.05);无营养风险组(A组)26例,有营养风险组(B组)14例,两组在放疗期间体质量丢失,去脂组织指数,骨骼肌量,相位角等人体成分指标变化差异有统计学意义(P<0.05).结论:胃癌患者在放疗期间营养状况有不同程度的损伤,且有营养风险的患者人体成分指标明显下降,因此,对放疗期间的患者进行营养风险筛查以及对营养风险的患者实施营养干预极为重要.

AIM：To study changes in body composition during radiotherapy for gastric cancer and explore the relationship between nutrition risk screen 2002（NRS-2002） and changes in body composition.METHODS：From June 2013 to June 2014,40 patients with gastric cancer received radiotherapy in Department of Radiation,Shanghai Cancer Center.Body composition was evaluated during radiotherapy using multifrequency bioelectrical impedance analysis.RESULTS：There were significant differences for changes in current weight（CW）,body mass index（BMI）,weight loss,fat mass index（FMI）,fat-free mass index（FFMI）,and body cell mass（BCM） during radiotherapy（P 〈 0.05）.There was no significant difference in skeletal muscle mass（SM） or phase angle（PA）（P 〉 0.05）.Changes in weight,FFMI,SM,and PA during radiotherapy significantly differed between patients with nutritional risk and those without.CONCLUSION：Nutritional deterioration was found during radiotherapy and body composition was significantly decreased in patients with nutritional risk.It is very important to make rational nutritional plan and intervene effectively for gastrointestinal cancer patients.