骨骼肌质量指数在非小细胞肺癌化疗患者中的变化及对预后的预测研究

Change of skeletal muscle mass index in non-small cell lung cancer patients with chemotherapy and its prognostic prediction

目的了解骨骼肌质量指数(skeletal muscle mass index,SMI)在非小细胞肺癌(non-small cell lung cancer,NSCLC)化疗患者中的变化,探讨其与患者预后的关系。方法采用便利抽样法,选择2017年3月—2018年3月在郑州大学第一附属医院化疗的85例NSCLC患者,比较化疗前后患者的SMI变化,并根据化疗前SMI值分为正常SMI组和低SMI组,随访患者生存情况,应用Kaplan-Meier法绘制生存曲线,采用Log-Rank检验比较两组生存预后。结果85例患者中,正常SMI患者61例,低SMI患者24例。有1例在接受化疗过程中死亡,最后84例患者完成全部化疗疗程。截至2020年3月,存活患者41例,死亡44例。84例患者化疗后的体重、BMI、四肢骨骼肌质量及SMI均较化疗前下降,差异有统计学意义(P<0.01);正常SMI组和低SMI组1年生存率分别为86.87%、62.50%,2年生存率分别为59.02%、20.83%;两组Kaplan-Meier曲线生存率比较差异有统计意义(Log-Rank=14.176,P<0.01)。结论NSCLC患者化疗后的SMI下降,低水平SMI患者生存状况越差。SMI可以作为NSCLC患者化疗生存预后的评估指标。

Objective To understand the change of skeletal muscle mass index(SMI)in non-small cell lung cancer(NSCLC)patients with chemotherapy,and to explore its relationship with the prognosis of patients.Methods From March 2017 to March 2018,convenience sampling was used to select 85 NSCLC patients who received chemotherapy in the First Affiliated Hospital of Zhengzhou University.We compared the change of SMI of patients before and after chemotherapy,and patients were divided into normal SMI group and low SMI group according to the SMI value before chemotherapy.The survival of those patients was followed up,the Kaplan-Meier method was used to draw the survival curve,and the Log-Rank test was used to compare the survival prognosis of two groups.Results Among 85 patients,61 patients with normal SMI and 24 patients with low SMI.One patient died during chemotherapy,and the last 84 patients completed the entire course of chemotherapy.As of March 2020,41 patients survived and 44 died.The weight,body mass index(BMI),skeletal muscle mass and SMI of 84 patients after chemotherapy decreased compared with those before chemotherapy,the differences were statistically significant(P<0.01).The one-year survival rates of normal SMI group and low SMI group were 86.87%and 62.50%,respectively,and the two-year survival rates were 59.02%and 20.83%respectively;the difference in Kaplan-Meier curve survival rate between two groups was statistically significant(Log-Rank=14.176,P<0.01).Conclusions The SMI of NSCLC patients decreased after chemotherapy,and the survival status of patients with low level of SMI was poor.SMI can be used as an evaluation index for the survival and prognosis of NSCLC patients with chemotherapy.