Glasgow预后评分与胃癌患者营养及体力状态关系的研究

Study on the relationship between Glasgow prognostic score and nutritional,physical status in patients with gastric cancer

目的观察基于全身炎症反应的GPS评分在胃癌患者营养及体力状态评估中的应用价值。方法回顾性收集2013年1月至2014年3月在我院住院、有人体成分测量及血液学数据的43例胃癌患者,从营养状态、体力状态及人体成分测量三方面分析GPS评分与患者营养及体力状态的关系。结果43例患者中男性18例,女性25例,GPS评分为0分、1分和2分者分别为27例、14例和2例。GPS评分与NRS2002评分及PG-SGA评分未发现显著的统计学关系,但与部分营养指标有关,GPS评分≥1分者前白蛋白水平较GPS评分为0分者显著降低(P=0.048);淋巴细胞计数有降低趋势(P=0.078)。分析GPS与体力状态的关系发现,GPS评分≥1分者Karnofsky功能状态评分更低(P=0.015),与生活质量评分有相关性趋势(P=0.076)。分析GPS评分与人体成分测量的关系发现,GPS评分≥1分者上臂中点周径明显小于GPS评分0分者(P=0.042),双侧小腿最大周径也明显减少(左右侧P值分别为0.023和0.03)。上臂肌肉周径、三头肌皮褶厚度及非利手握力均有减少,但未达到显著的统计学差异。结论基于全身炎症反应的GPS评分与胃癌患者的部分营养指标及体力状态有关,因此有望成为胃癌患者营养及体力状态评估的简化替代指标。

Objective To observe the value of Glasgow prognostic score(GPS)based on systemic inflammatory response in evaluating nutritional status and performance status in patients with gastric cancer.Methods 43 patients with gastric cancer hospitalized in our hospital from January 2013 to March 2014 with body composition measurement and hematological data were collected.The relationship between GPS score and nutritional,performance status were analyzed.Results In 43 gastric cancer patients,there were 18 males and 25 females.There were 27,14 and 2 patients with GPS scores of 0,1 and 2,respectively.It was found there was no significant statistical relationship between GPS score with NRS 2002(nutrition risk screening,NRS 2002)score and PG-SGA(patient-generated subjective global assessment)score.The serum level of prealbumin in patients with GPS score≥1 was significantly lower than that of patients with GPS score 0(P=0.048),and there was a trend to decline in blood lymphocyte count(P=0.078).The KPS score of patients with GPS score≥1 was lower(P=0.015),and there was a trend of correlation between GPS and quality of life(P=0.076).In analysis involving body composition measurement,the mid-upper arm circumference in patients with GPS score≥1 turned to be significantly smaller than that of GPS score 0(P=0.042).The maximum circumferences of both legs were also obviously smaller in patients with GPS≥1 than that of GPS 0.The upper arm muscle circumference,triceps skin fold thickness and non-dominant hand grip strength were all reduced,but no significant statistical difference was found between patients with GPS≥1 and GPS 0.Conclusion GPS score is based on systemic inflammatory response and related to parts of nutritional indicators and performance status of gastric cancer patients.It is a promising simplified alternative index for nutritional and performance status assessment of gastric cancer patients.