β-羟基-β-甲基丁酸对Ⅰ~Ⅲ期老年结肠癌手术患者营养不良的改善效果评估

Effect of HMB on the nutritional improvement in elderly surgical patients with stage Ⅰ-Ⅲ colon cancer

目的研究存在营养不良的老年Ⅰ~Ⅲ期结肠癌患者围手术期在口服营养补充的基础上添加β-羟基-β-甲基丁酸(β-hydroxy-β-methylbutyrate,HMB)组件对患者术后营养状况的改善效果。方法选取2020年1月至2021年3月首都医科大学附属北京世纪坛医院、昆明医科大学第一附属医院、哈尔滨医科大学附属第四医院、同济大学附属第十人民医院行结肠癌根治术的Ⅰ~Ⅲ期老年结肠癌患者59例,分为HMB观察组(31例)和对照组(28例),通过肿瘤患者主观整体营养评估(Patient-Generated Subjective Global Assessment,PG-SGA)、微型营养评定简表(Mini-Nutritional Assessment Short-Form,MNA-SF)得分情况评估患者术前、术后营养状况以及术后恢复情况。检测患者术前和术后血红蛋白、人血白蛋白、总胆固醇、甘油三酯水平。评价两组患者各指标在术前、术后变化情况。结果观察组术后30d PG-SGA、MNASF得分情况均优于对照组(P<0.05)。术后30d观察组血红蛋白水平优于对照组[(129.8±16.6)g/L vs.(119.3±12.0)g/L,P=0.019]。对于术前体重丢失大于2.5%的患者,术后30d观察组血红蛋白、白蛋白水平均优于对照组(P<0.05)。结论在口服营养补充的基础上添加HMB组件对术前存在营养不良的老年结肠癌患者术后营养状况有改善作用。

Objective To study the effect of oral nutritional supplements containing β-hydroxy-β-methylbutyrate(HMB)on the nutritional status in elderly patients with stage Ⅰ-Ⅲ colon cancer.Method A total of 59 elderly patients with stage Ⅰ-Ⅲ colon cancer who underwent radical resection from January 2020 to March 2021 were enrolled.31 patients were selected into HMB group and 28 patients were divided into control group.Preoperative and postoperative nutritional status and postoperative recovery situation were evaluated by Patient-Generated Subjective Global Assessment(PG-SGA)and Mini-Nutritional Assessment Short-Form(MNA-SF).The levels of hemoglobin,serum albumin,total cholesterol,and triglycerides were measured before and after surgery.The changes of these parameters were compared before and after surgery.Result The scores of PG-SGA and MNA-SF of HMB group were improved significantly after surgery(P<0.05),while control group did not.The hemoglobin level in HMB group was higher than that in control group at 30 days after operation[(129.8±16.6)g/L vs.(119.3±12.0)g/L,P=0.019].For patients with preoperative weight loss greater than 2.5%,the hemoglobin and albumin levels in HMB group were higher than control group at 30 days after surgery(P<0.05).Conclusion Oral nutritional supplements with HMB components can improve postoperative nutritional status for elderly patients with colon cancer.