老年食管癌患者术前PG-SGA评分与营养相关血液学指标的相关性研究

The correlation between preoperative PG-SGA score and nutrition-related hematology indicators in elderly patients with esophageal cancer

目的探讨患者主观整体评估(PG-SGA)评分与营养相关血液学指标水平在老年食管癌术前营养评估中的相关性。方法回顾性研究2018年1月至2020年3月在辽宁省肿瘤医院胸外科接受食管癌手术治疗的115例老年患者的入院PG-SGA评分和营养相关血液学指标前白蛋白(PA)、白蛋白(ALB)、血红蛋白(HGB)、红细胞计数(RBC)水平等,按是否需要进行营养干预将患者分为无/可疑营养不良组(PG-SGA<4分)和中/重度营养不良组(PG-SGA≥4分),比较两组患者的营养相关血液学指标,以及PG-SGA评分与营养相关血液学指标的相关性。结果中/重度营养不良组的PA、ALB、RBC和HGB水平均低于无/可疑营养不良组(P均<0.05)。患者术前PG-SGA评分与PA、ALB、RBC和HGB水平均呈负相关(P<0.05)。PA、ALB、RBC、HGB判断中/重度营养不良的临界值分别为215.5 mg/L、39.55 g/L、4.65×10^12/L、152.5 g/L。结论老年食管癌患者术前中、重度营养不良发生率较高,中、重度营养不良患者的PA、ALB、RBC和HGB水平均明显下降,且与PG-SGA评分呈明显负相关。应用PG-SGA评分结合上述血液学指标能够提高老年食管癌患者术前营养风险评估的准确性,从而为合理制定术前营养干预方案提供可靠依据。

Objective To investigate the correlation between Patient-Generated Subjective Global Assessment(PG-SGA)and the level of nutrition-related hematology indicators in preoperative nutritional assessment of elderly esophageal cancer.Methods This was a retrospective study.115 elderly patients who underwent esophagectomy for esophageal cancer in the thoracic surgery department of Liaoning Cancer Hospital from January 2018 to March 2020 were included in the study.The PG-SGA score and nutrition-related hematology indicators including pre-albumin(PA),albumin(ALB),hemoglobin(HGB)and red hematology cell count(RBC)levels on admission were collected.According to whether nutritional interventions were needed,patients were divided into non/suspicious malnutrition group(PG-SGA<4)and moderate/severe malnutrition group(PG-SGA≥4).The nutrition-related hematology indicators of the two groups were compared,and the correlation between PG-SGA score and the nutrition-related hematology indicators was assessed.Results The PA,ALB,RBC and HGB levels of patients in the moderate/severe malnutrition group were lower than those in the non/suspected malnutrition group,and the difference was statistically significant(P<0.05).The preoperative PG-SGA score was negatively correlated with PA,ALB,RBC and HGB levels(P<0.05).When PG-SGA≥4,the optimum cutoff value for PA,ALB,RBC and HGB was 215.5 mg/L,39.55 g/L,4.65×10^12/L and 152.5 g/L,respectively.Conclusion The incidence of moderate/severe malnutrition in elderly patients with esophageal cancer is high preoperatively.And the levels of PA,ALB,RBC and HGB in patients with moderate/severe malnutrition are significantly decreased and these indicators has significantly negtive correlation with PG-SGA score.The application of PG-SGA score combined with the above hematology indicators can improve the accuracy of preoperative nutritional risk assessment for elderly patients with esophageal cancer,so as to provide a reliable basis for the rational formulation of preoperative nutritional intervention program.