食管癌化疗患者维生素水平变化横断面研究

A cross-sectional study of changes of vitamin levels in patients with esophageal cancer receiving chemotherapy

目的研究食管癌患者化疗期间维生素水平变化情况。方法选取2017年7月至2020年9月中国人民解放军联勤保障部队第九一〇医院243例接受化疗的食管癌患者的临床资料。检测食管癌患者化疗前1周内、化疗2个周期后的血维生素A、B1、B2、B6、B9(叶酸)、B12、C、D、E共9种维生素水平、血液学指标和体质指数(BMI)的变化。比较食管癌患者化疗2个周期后9种维生素缺乏例数和平均水平的变化情况。使用Pearson相关分析患者化疗前后各种维生素水平差异与BMI变化间的相关性。结果纳入的243例患者年龄39~76岁,平均(60.14±8.26)岁。食管癌分期以Ⅲ期117例(48.15%)和Ⅳ期80例(32.92%)为主。初始治疗前的食管癌患者存在维生素A、B2、C、D水平不足(均P<0.05)。化疗2个周期后,患者维生素A、B2、B6和C水平显著降低(均P<0.05)。化疗2个周期后患者的体质指数、血红蛋白、总蛋白、血清白蛋白和血钙水平降低(均P<0.05),血磷水平显著升高(P<0.05)。化疗前及化疗2个周期后患者的血维生素A(r=0.343,P<0.001)和C水平(r=0.388,P<0.001)变化与体质指数的变化呈正相关。结论接受化疗的食管癌患者存在维生素A、B2、C和D缺乏。

Objective To study the changes of vitamin levels in patients with esophageal cancer during chemotherapy.Method The clinical data of 243 patients with esophageal cancer who received chemotherapy in the No.910 Hospital of PLA from July 2017 to September 2020 were selected.The levels of nine vitamins[A,B1,B2,B6,B9(folic acid),B12,C,D,E],hematological indexes and body mass index(BMI)in patients with esophageal cancer were measured before and after two cycles of chemotherapy.The changes of the number and average level of 9 vitamin deficiency patients in patients with esophageal cancer after two cycles of chemotherapy were compared.Pearson correlation score was used to analyze the correlation between the differences of various vitamin levels and the changes of BMI before and after chemotherapy.Result the age of 243 patients ranged from 39 to 76 years,with an average of(60.14±8.26)years.The main stages of esophageal cancer were stageⅢ117 cases(48.15%)and stageⅣ80 cases(32.92%).The level of vitamin A,B2,C and D in patients with esophageal cancer before initial treatment was lower than the normal value(P<0.05).After 2 cycles of chemotherapy,the levels of vitamin A,B2,B6 and C decreased significantly(P<0.05).After two cycles of chemotherapy,the levels of hemoglobin,total protein,serum albumin and blood calcium decreased,and the level of blood phosphorus increased significantly(P<0.05).The changes of blood vitamin A(r=0.343,P<0.001)and C(r=0.388,P<0.001)were positively correlated with the changes of BMI.Conclusion There are vitamin A,B2,C and D deficiencies in patients with esophageal cancer receiving chemotherapy.