晚期肿瘤患者营养状况与焦虑、抑郁的相关性分析

Nutritional status of advanced cancer patients and its correlation with anxiety and depression

目的研究晚期肿瘤患者营养状况与焦虑、抑郁不良情绪的相关性。方法筛选2019年1月至2020年1月在重庆市巴南区人民医院肿瘤科住院的晚期肿瘤患者,调查营养风险筛查2002(NRS 2002)评分、体质指数(BMI)、血液学指标(总蛋白、白蛋白、血红蛋白);用住院患者焦虑抑郁量表(HADS)对患者的焦虑、抑郁情况进行评估;分析晚期肿瘤患者营养状况与焦虑、抑郁之间的关系。结果1501例晚期肿瘤患者中22.39%(336/1501)的患者BMI<18.5 kg/m^(2),NRS 2002≥3分发生率为56.70%(851/1501)。存在营养风险患者总蛋白、白蛋白、血红蛋白以及BMI更低;比较不同癌种,晚期消化道肿瘤患者营养不足及存在营养风险比例最高。焦虑症状阳性率为78.61%(1180/1501),抑郁症状阳性率为69.62%(1045/1501),NRS 2002评分与焦虑、抑郁呈正相关;BMI与焦虑、抑郁呈负相关。结论晚期肿瘤患者营养不足、营养风险发生率高,焦虑、抑郁不良情绪普遍,NRS 2002评分越高,BMI越低,焦虑抑郁程度越重。针对营养风险高、营养不足的晚期肿瘤患者我们应加强营养治疗以及对焦虑、抑郁不良情绪的干预。

Objective To study the nutritional status of patients with advanced cancer and its correlation with anxiety and depression.Methods To screening the advanced cancer patients hospitalized in the oncology department of our hospital from January 2019 to January 2020,and investigate the nutritional risk screening 2002(NRS 2002)score,body mass index(BMI),hematological indexes(total protein,albumin,hemoglobin).The hospital anxiety and Depression Scale(HADS)was used to evaluate the patients′anxiety and depression,and to analyze the relationship between nutritional status and anxiety and depression in patients with advanced cancer.Results The incidence of malnutrition(BMI<18.5 kg/m^(2))was 22.39%(336/1501),and the incidence of nutritional risk(NRS 2002≥3)was 56.70%(851/1501).Patients with nutritional risk had lower total protein,albumin,hemoglobin and BMI.Compared with different kinds of cancer,patients with advanced gastrointestinal cancer had the highest proportion of malnutrition and nutritional risk.The positive rates of anxiety and depression were 78.61%(1180/1501)and 69.62%(1045/1501),respectively.NRS 2002 score was positively correlated with anxiety and depression(P<0.05);BMI was negatively correlated with anxiety and depression(P<0.05).Conclusion The higher the NRS 2002 score,the lower the BMI,and the more serious the degree of anxiety and depression.For advanced cancer patients with high nutritional risk and malnutrition,we should strengthen nutritional support and the intervention of anxiety and depression.