抑郁对鼻咽癌放疗患者营养状况的影响

Effect of depression on nutritional status of patients with nasopharyngeal carcinoma receiving radiotherapy

目的评估抑郁症状对接受放射治疗的鼻咽癌患者营养状况的影响。方法根据放疗开始前医院焦虑和抑郁量表(HAD)量表的评估结果,将符合纳入标准的77例鼻咽癌患者分为抑郁组和非抑郁组。在放疗开始前及放疗结束时观察评估抑郁组(n=32)和非抑郁组(n=45)的营养状况变化,并分析抑郁对于患者营养状况变化的影响。结果放疗前约有41.6%的患者存在抑郁症状,抑郁组患者放疗结束时的血清白蛋白和血红蛋白水平显著低于非抑郁组[(38.5±5.8)mg/dl vs(41.0±5.2)mg/dl,P=0.045;(108.3±31.6)g/L vs(111.6±16.6)g/L,P=0.041],抑郁组患者放疗结束时更容易出现体重下降≥5%、BMI<18.5kg/m 2及NRS 2002评分≥3分(75.0%vs 33.3%,P=0.001;28.1%vs 8.9%,P=0.026;46.9%vs 17.8%,P=0.006)。结论鼻咽癌患者的抑郁症状与患者的营养状况密切相关。在接受放疗的鼻咽癌患者中,抑郁症状也许可以作为患者出现营养不良的预测指标。

Objective To evaluate the effect of depressive symptoms on the nutritional status of patients with nasopharyngeal carcinoma receiving radiotherapy.Methods According to the evaluation results of the HAD scale before radiotherapy,77 patients with nasopharyngeal carcinoma who met the inclusion criteria were divided into the depressive group and the non-depressive group.Observe and evaluate the nutritional status changes of depression group(n=32)and non-depression group(n=45)before radiotherapy and the end of radiotherapy,and analyze the effect of depression on the nutritional status of patients.Results In this study,we found that about 41.6%of patients had depressive symptoms before radiotherapy.The average serum albumin and hemoglobin levels in the depression group at the end of radiotherapy were significantly lower than those in the non-depression group[(38.5±5.8)mg/dl vs(41.0±5.2)mg/dl,P=0.045;(108.3±31.6)g/L vs(111.6±16.6)g/L,P=0.041],patients in depression group were more prone to weight loss≥5%,BMI<18.5kg/m 2 and NRS 2002 score≥3(75.0%vs 33.3%),P=0.001;28.1%vs 8.9%,P=0.026;46.9%vs 17.8%,P=0.006).Conclusion The depressive symptoms of patients with nasopharyngeal carcinoma are closely related to their nutritional status.In patients with nasopharyngeal carcinoma receiving radiotherapy,depressive symptoms may be used as predictors of malnutrition.