食管癌手术病人相位角与营养状况的相关性研究

A correlation study between phase angle of bioelectrical impedance analysis and Nutritional status in patients with esophageal cancer undergoing surgery

目的:探讨生物电阻抗法(相位角)与食管癌手术病人营养风险及营养状况的相关性。方法:73例食管癌手术病人应用营养风险筛查2002(NRS 2002)、采用欧洲肠外肠内营养学会营养不良诊断共识及病人主观整体评估法(patient-generated subjective global assessment,PG-SGA)、白蛋白、前白蛋白、人体成分分析,人体测量、握力,PA评价其营养风险及营养状况的相关。结果:PA与BMI、上臂肌围、上臂围、大腿围、前白蛋白、肌酐、HGB、RBC呈正相关性(P <0.05);PA与PG-SGA呈负相关性(P <0.05)。按PG-SGA评价营养不良分组,结果显示营养良好组PA值明显高于可疑或中度营养不良+重度营养不良组(P <0.05);按ESPEN营养不良诊断共识分组,发现营养良好组PA值高于营养不良组(P=0.069);按NRS 2002分组,发现无营养风险组PA值稍高于营养风险组,(P=0.792)。按PALB分组,发现PALB正常组PA值明显高于PALB偏低组,(P <0.05);按PNI均值分组,发现高PNI组PA值稍高于低PNI组,(P=0.338)。结论:PA与多项营养指标密切相关,PA测量有助于快速判断病人是否存在营养风险,为及时进行营养干预的实施提供了客观依据。

Objective: To explore the correlation between phase angle(PA)of bioelectrical impedance analysis(BIA) and nutritional risk or nutritional status in patients with esophageal cancer undergoing surgery. Methods: 73 patients with esophageal cancer undergoing surgery were included, and the correlation between nutritional risk or nutritional status was evaluated for nutritional risk and nutritional status by nutritional risk screening(NRS 2002),european society parenteral and enteral nutrition(ESPEN) consensus on the diagnosis of malnutrition, patient-generated subjective global assessment(PG-SGA), albumin, prealbumin, BIA, anthropometric measures, and grip. Results: The PA values were positively correlated with BMI, upper arm muscle circumference, upper arm circumference, thigh circumference, prealbumin(PALB), creatinine, HGB and RBC(P < 0.05), and were negatively correlated with PG-SGA(P < 0.05). On the basis of the criteria of PG-SGA, the PA values in the patients with non-malnutrition were significantly higher than those of the patients with malnutrition(P < 0.05). According to the ESPEN consensus, the PA values in the patients with non-malnutrition were higher than those of the patients with malnutrition(P = 0.069). Based on NRS 2002,the PA values in the patients with non-malnutrition were a little higher than those of the patients with malnutrition(P =0.792). In the light of PALB, the PA values in the patients with normal value were significantly higher than those of the patients with low value(P < 0.05). On the ground of prognostic nutritional index(PNI), the PA values in the patients with high value were a little higher than those of the patients with low value(P = 0.338). Conclusion: PA has a significant correlation with nutritional indices and is helpful to identify the patients with nutritional risk, and thereby provides an objective evidences of the nutritional intervention.