血红蛋白联合营养风险筛查对恶性肿瘤患者癌因性疲乏的预测效果分析

Predictive effect of hemoglobin combined with nutritional risk screening on cancer-related fatigue in cancer patients

目的探讨血红蛋白联合营养风险筛查对恶性肿瘤患者癌因性疲乏(CRF)的预测效果。方法回顾性选取2021年7月至2022年1月入安徽医科大学第二附属医院全科医学科接受治疗的患者80例为对象。采用癌症疲乏量表(CFS)对肿瘤患者疲乏症状进行评估,按照评分分为无疲乏症状、轻度疲乏、中度疲乏和重度疲乏。分析肿瘤患者治疗后CRF和各维度疲乏现状,对不同程度CRF患者的营养风险情况和营养指标进行对比分析,采用受试者工作特征(ROC)曲线分析血红蛋白、营养风险筛查量表(NRS-2002)评分以及二者联合应用在CRF中的预测价值。结果肿瘤患者治疗后CRF总得分为(33.65±7.56)分,其中躯体疲乏、认知疲乏、情感疲乏分别为(16.83±4.53)、(8.34±2.69)、(8.48±2.29)分,各维度评分以及总疲乏评分中中度疲乏评分的构成比最高;轻度疲乏、中度疲乏和重度疲乏中肿瘤患者无营养风险的占比均高于有营养风险的占比,差异有统计学意义(P<0.05);重度疲乏患者的血红蛋白水平明显低于中度和轻度疲乏患者,中度疲乏患者的血红蛋白水平显著低于轻度疲乏患者,差异均有统计学意义(P<0.05)。轻度疲乏、中度疲乏和重度疲乏中肿瘤患者有营养风险的占比均高于无营养风险的占比,差异有统计学意义(P<0.05)。血红蛋白、NRS-2002评分以及血红蛋白和NRS-2002评分联合应用预测肿瘤患者发生CRF的ROC曲线下面积(AUC)分别为0.792(95%CI:0.717~0.868)、0.619(95%CI:0.532~0.706)和0.892(95%CI:0.854~0.951),两者联合预测肿瘤患者发生CRF的AUC值明显大于单独应用血红蛋白和NRS-2002评分,差异均有统计学意义(P<0.05)。结论血红蛋白联合NRS-2002能够较为准确地预测肿瘤患者CRF情况,具有较高的评估价值,值得临床推广应用。

Objective To investigate the predictive effect of hemoglobin combined with nutritional risk screening on cancer-related fatigue(CRF)in cancer patients.Methods Eighty patients admitted to the Department of General Medicine,the Second Affiliated Hospital of Anhui Medical University from July 2021 to January 2021 were retrospectively selected as the subjects.The cancer fatigue scale(CFS)evaluates the fatigue symptoms of cancer patients,and were divided into no fatigue symptoms,mild fatigue,moderate fatigue and severe fatigue according to the score.The current status of CRF and various dimensions of fatigue in cancer patients after treatment was analyzed.The nutritional risk status and nutritional indicators of fatigue patients were compared and analyzed,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of hemoglobin,nutritional risk screening score(NRS-2002)and their combined application in CRF.Results The total score of CRF in cancer patients after treatment was(33.65±7.56)points,of which physical fatigue,cognitive fatigue,and emotional fatigue were(16.83±4.53),(8.34±2.69),and(8.48±2.29)points,respectively.The proportion of moderate fatigue score in each dimension score and total fatigue score was the highest;in mild fatigue,moderate fatigue and severe fatigue,the proportion of tumor patients without nutritional risk was higher than that with nutritional risk,and the difference was statistically significant(P<0.05).The levels of hemoglobin in patients with severe fatigue were significantly lower than those in patients with moderate fatigue,and the levels of hemoglobin in patients with moderate fatigue were significantly lower than those in patients with mild fatigue,the differences were statistically significant(P<0.05).The AUC of hemoglobin,NRS-2002 score and the combined application of hemoglobin and NRS-2002 score to predict CRF in tumor patients were 0.792(95%CI:0.717-0.868),0.619(95%CI:0.532-0.706)and 0.892(95%CI:0.854-0.951),the AUC value of the combination of the two methods in predicting CRF in cancer patients was significantly higher than that of hemoglobin alone and NRS-2002 score,and the difference was statistically significant(P<0.05).Conclusion Hemoglobin combined with NRS-2002 can more accurately predict CRF in tumor patients,and has a high evaluation value,which is worthy of clinical promotion and application.