肺癌患者化学治疗期间营养不良发生情况及相关影响因素分析

Incidence of Malnutrition and Related Influencing Factors in Patients with Lung Cancer during Chemotherapy

目的探讨肺癌患者化学治疗期间营养不良发生情况及相关影响因素。方法选取行化学治疗的肺癌560例,采用患者主观整体评估(scored patient-generated subjective global assessment,PG-SGA)量表评估其营养状况(PG-SGA量表评分≥4分为营养不良),将其分为营养不良组和非营养不良组,记录比较两组一般资料、营养摄入情况及化学治疗不良反应,采用多因素Logistic回归分析对肺癌患者化学治疗期间营养不良发生相关影响因素进行分析。结果PG-SGA量表评分结果显示,560例肺癌中314例(56.07%)营养不良(营养不良组),246例(43.93%)非营养不良(非营养不良组)。两组年龄、体质量指数、文化程度、家庭月收入、是否抑郁、有无肠外营养支持、TNM分期及呕吐、腹泻发生情况比较差异有统计学意义(P<0.05或P<0.01)。营养不良组摄入蛋白质、脂肪及维生素C低于非营养不良组,差异有统计学意义(P<0.01)。多因素Logistic回归分析结果显示,年龄≥60岁、家庭月收入<5000元、抑郁、TNM分期Ⅲ和Ⅳ期及呕吐Ⅲ和Ⅳ级是肺癌患者化学治疗期间营养不良发生的危险因素,肠外营养支持及摄入蛋白质是肺癌患者化学治疗期间营养不良发生的保护因素(P<0.05或P<0.01)。结论肺癌患者化学治疗期间营养不良发生率较高,年龄≥60岁、家庭月收入<5000元、抑郁、TNM分期Ⅲ和Ⅳ期及呕吐Ⅲ和Ⅳ级是肺癌患者化学治疗期间营养不良发生的危险因素,肠外营养支持及摄入蛋白质是肺癌患者化学治疗期间营养不良发生的保护因素。

Objective To investigate the incidence of malnutrition in patients with lung cancer during chemotherapy,and to further analyze the related influencing factors of malnutrition.Methods A total of 560 patients with lung cancer who underwent chemotherapy were divided into malnutrition group and non-nutrition group by patient-generated subjective global assessment(PG-SGA)(PG-SGA score≥4 was classified as malnutrition group).The general information,nutritional intake and adverse reactions of chemotherapy were recorded and compared,and multivariate logistic regression analysis was used to analyze the influencing factors of malnutrition in patients with lung cancer during chemotherapy.Results According to the results of PG-SGA scale,among 560 patients with lung cancer,314(56.07%)were malnourished(malnutrition group),and 246(43.93%)were non-malnourished(non-malnutrition group).There were statistically significant differences in age,body mass index,education level,family monthly income,depression,parenteral nutrition support,TNM stage,vomiting,and diarrhea between the two groups(P<0.05 or P<0.01).The intake of protein,fat and vitamin C in the malnutrition group was lower than that in the non-malnutrition group(P<0.01).Multivariate logistic regression analysis showed that age≥60 years,family monthly income<5000 yuan,depression,TNM stage Ⅲ-Ⅳ,grade Ⅲ-Ⅳ vomiting were the risk factors,while parenteral nutrition support and protein intake were protective factor for incidence of malnutrition in patients with lung cancer during chemotherapy(P<0.05 or P<0.01).Conclusion The incidence of malnutrition is higher in patients with lung cancer during chemotherapy.Age≥60 years,family monthly income<5000 yuan,depression,TNM stages Ⅲ-Ⅳ,grade Ⅲ-Ⅳ vomiting are risk factors,while parenteral nutrition support and protein intake are protective factors for incidence of malnutrition in patients with lung cancer during chemotherapy.