肝癌患者营养状态与肝功能、炎症因子及预后的相关性分析

Correlation analysis of nutritional status with liver function,inflammatory factors and prognosis in patients with liver cancer

目的探讨肝癌患者营养状态与肝功能、炎症因子及预后的相关性。方法选取2019年1月至2020年12月在巴彦淖尔市医院行半肝切除术治疗的原发性肝癌患者170例临床资料进行回顾性分析。通过患者主观整体评估(PG-SGA)结果将患者进行分组,0~≤1分组(13例)、2~≤3分组(34例)、4~≤8分组(58例)、≥9分组(65例)。比较各组患者肝功能指标与炎症因子水平差异,分析PG-SGA评分与肝功能指标、炎症因子水平的相关性,并比较营养良好组(4~≤8分组+≥9分组)、营养不良组(0~≤1分组+2~≤3分组)预后生存状态。结果PG-SGA≥9分组患者直接胆红素(DBIL)、总胆红素(TBIL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)分别高于0~≤1分组、2~≤3分组、4~≤8分组(F=20.870、18.633、835.004、1190.48、26.283、28.242、31.109,P<0.05),白蛋白(ALB)分别低于0~≤1分组、2~≤3分组、4~≤8分组(F=-18.755,P<0.05)。Pearson相关性分析显示:PG-SGA评分与ALB呈负相关(r=-0.403,P<0.05),与DBIL、TBIL、ALT、AST、TNF-α、IL-1、IL-6呈正相关(r=0.412、0.451、0.862、0.849、0.530、0.543、0.515,P<0.05)。Kaplan-Meier生存分析显示,营养良好组总生存情况优于营养不良组(χ^(2)=6.364,P<0.05)。结论肝癌患者多存在营养不良状况,且营养状态与肝功能、炎症因子及预后相关密切,临床需注重肝癌患者营养状态监测,保证患者术前营养状态良好.

Objective To investigate the Correlation analysis of nutritional status with liver function,infammatory factors and prognosis in patients with liver cancer.Method The clinical data of 170 patients with primary hepatocellular carcinoma admitted for hemibepatectomy treatment in Bayannur Hospital from Janwary 2019 to December 2020 were selected for retrospective analysis.The patients were grouped by the subjective overall nutritional status asessment scale(PG--SCA)asessment resuls with0-≤1 group(13 cases),2-≤3 group(34 cases),4-≤8 group(58 cases),and≥9 group(65 cases).We compared the dfferences in liver function indexes and inflammatory factor levels of patients in each group,analyzed the correlation between PG-SGA scores and liver function indexes and inlammatory factor levels,and compared the prognostic survival status of the well-nourished group(group4-≤8+group≥9),and the malnourished group(group 0-≤1+group 2-≤3).Result Direct bilirubin(DBIL),total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT),interleukin-6(IL-6),tumor necosis factor-α(TNF-α),and interleukin-1(IL-1)were higher than those in subgroups 0-≤1,2-≤3,and 4-≤8,respectively,in patients of subgroups≥9 of PG-SGA(F=20.870,18.633,835.004,1190.48,26.283,28.242,31.109,P<0.05),and albumin(ALB)were lower than subgroups 0-≤1,2-≤3,and 4-≤8,respectively(F=-18.755,P<0.05).Person correlation analysis showed that PG-SGA score had a negative orrelation with ALB(r=-0.403,P<0.05)and a positive orrelation with DBIL,TBIL,ALT,AST,TNF-α,IL-1,IL-6(r=0.412.0.451.0.862.0.849.0.5300.543.0.515,P<0.05).Kaplan-Meier survival Analysis showed that overall survival was better in the well-nourished group than in the malnourished group(χ^(2)=6.364,P<0.05).Conclusion Most liver cancer patients have malnutrition,and the nuttitional status is closely related to liver function,inflammation factor and prognosis.The more severe the malnutrition is,the worse the liver function is,the more severe the inlammation level is,and the worse the prognosis is;clinics need to focus on monitoring the nutritional status of liver cancer patients to ensure that patients have good nutritional status before surgery.