实体瘤患儿治疗期间营养状况及影响因素分析

Nutritional status and influencing factors of children with solid tumors during treatment

目的评估实体瘤患儿治疗期间的营养状况,并探讨其影响因素。方法选取2019年11月至2020年8月上海交通大学医学院附属上海儿童医学中心收治的109例实体瘤患儿作为病例组,同期选取该院门诊进行营养咨询的109例健康儿童(与病例组年龄、性别构成比接近)作为对照组。收集研究对象的临床资料,使用生物电阻抗分析方法对两组进行人体成分测定,比较病例组和对照组营养指标的差异,分析实体瘤患儿治疗期间营养状况的影响因素。结果根据身体质量指数(body mass index,BMI)Z评分对营养状况进行分组,BMI Z评分<-1为营养不良,-1≤BMI Z评分≤2为营养正常。病例组中营养不良41例(37.6%),营养正常68例(62.4%)。病例组BMI、去脂体重质量指数和身体细胞质量指数均显著低于对照组(P<0.001)。多因素Logistic回归分析显示,诊断时营养状况、感染、黏膜炎是实体瘤患儿治疗期间营养状况的独立影响因素(P<0.05)。结论实体瘤患儿治疗期间营养不良发生率高,人体成分测定能准确评估实体瘤患儿的营养状况。诊断时营养不良、治疗期间合并感染或黏膜炎是影响实体瘤患儿治疗期间营养状况的独立危险因素。

Objective To explore the effects of risk factors on nutritional status of children with solid tumors during treatment.Methods From November 2019 to August 2020,109 children with solid tumors were selected as the case group and another 109 age-matched and sex-matched healthy children were chosen as the control group.The clinical data of two groups was collected,and their body composition using bioelectrical impedance analysis was measured to compare the differences in nutritional indicators.Results The children's nutritional status was defined by the body mass index z-score(BMIZ):BMIZ<-1 indicates malnutrition,-1≤BMIZ≤2 indicates normal.In the case group,41(37.6%)patients was malnutrition,68(62.4%)was normal.The BMI,fat-free mass index and body cell mass index of the case group were significantly lower than those of the control group.According to the Multivariate Logistic regression analysis,nutritional status at diagnosis,infection and mucositis were the independent factors affecting the nutritional status of children with solid tumors during treatment.Conclusion Children with solid tumors have high incidence of malnutrition.The body composition analysis can facilitate more accurate assessment of nutritional status of children with solid tumors.Malnutrition at diagnosis,infection or mucositis during treatment were the independent influencing factors for nutritional status of children with solid tumors.