胃癌患者血浆维生素 C 水平与营养及炎症指标的相关性
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摘要目的探讨胃癌患者血浆维生素 C 水平与其营养及炎症指标的相关性。方法选取 2023 年 7 月至 12 月在广西医科大学第一附属医院收治的胃癌患者 156 例。采用营养风险筛查 2002(NRS 2002)和患者主观整体评估(PG-SGA)于患者入院 24 h 内评估其营养风险及营养状况,同时测定血浆维生素 C 及炎症相关生化指标并计算炎症相关指数,对维生素 C 不同分组 (<2 mg / L, ≥2 mg / L)的各指标进行单因素分析及多因素 Logistic 分析。结果 156 例胃癌患者中,60. 26%(94 / 156)存在维生素 C 不足。在 46. 79%(73 / 156)存在营养风险的患者中,73. 97%(54 / 73)存在维生素 C 不足。根据 PG-SGA 结果进行营养状态判定,在 68. 59%(107 / 156)存在中/ 重度营养不良的患者中,70. 09%(75 / 107)存在维生素 C 不足。同时重度营养不良的患者中 82. 46%(47 / 57)存在维生素 C 不足。高维生素 C 患者的白蛋白(ALB)、前白蛋白(PPA)、淋巴细胞与单核细胞比值 (LMR)、预后营养指数(PNI)及 C 反应蛋白-白蛋白-淋巴细胞指数(CALLY)显著高于低维生素 C 患者,而 NRS 2002 评分、 PG-SGA 评分、白细胞介素-6(IL-6)、C 反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)、系统免疫炎症指数( SII)显著低于低维生素 C 组。多因素 Logistic 回归分析结果显示 PG-SGA 评分、IL- 6、CRP 是维生素 C 缺乏的独立危险因素(P< 0. 05)。结论胃癌患者出现维生素 C 不足的比例较高,存在营养风险或营养不良的患者更易出现维生素 C 不足,维生素 C 和营养及炎症指标之间可能存在一定的相关性,胃癌患者应常规监测维生素 C 含量。

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	1谭明浩
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	2吴向华

关键词 ：胃癌, 维生素 C, 营养风险, 营养不良, 炎症相关指数, 营养风险筛查 2002, 患者主观整体评估, 血清炎症指标

Abstract：Objective To investigate the correlation between vitamin C levels nutritional indicators and inflammatory parameters in gastric cancer patients. Method 156 cases of gastric cancer patients were selected from those admitted to the First Affiliated Hospital of Guangxi Medical University between July and December 2023. Nutritional risk screening 2002 NRS 2002 and patient-generated subjective global assessment PG-SGA were used to evaluate the nutritional risk and nutritional status within 24 hours of admission. Meanwhile serum vitamin C levels and inflammatory markers were measured and the inflammatory-related indices were calculated. Single-factor analysis and multiple-variable Logistic regression analysis were performed to analyze the indicators for different vitamin C groups. Result Among the 156 gastric cancer patients 60. 26% 94 / 156 exhibited vitamin C deficiency. Among the 46. 79% 73 / 156 patients with nutritional risk 73. 97% 54 / 73 had vitamin C deficiency. According to the PG-SGA results moderate or severe malnutrition was identified in 68. 59% 107 / 156 of the patients with 70. 09% 75 / 107 exhibiting vitamin C deficiency and 82. 46% 47 / 57 of patients with severe malnutrition had vitamin C deficiency. Among the patients with high vitamin C albumin ALB prealbumin PA lymphocyte -to -monocyte ratio LMR prognostic nutritional index PNI and C- reactive protein - albumin - lymphocyte index CALLY were significantly higher than the patients with low vitamin C while NRS 2002 score PG-SGA score interleukin-6 IL-6 C-reactive protein CRP neutrophil to lymphocyte ratio NLR and systemic immune-inflammatory index SII were significantly lower than the patients with low vitamin C P< 0. 05 . Logistic regression analysis revealed that PG-SGA score IL-6 and CRP were independent risk factors for vitamin C deficiency P<0. 05 . Conclusion The proportion of gastric cancer patients with insufficient vitamin C is relatively high and patients with nutritional risk or malnutrition are more prone to vitamin C deficiency. Gastric cancer patients should regularly monitor vitamin C levels.

Key words： Gastric cancer Vitamin C Nutritional risk Malnutrition Inflammation-related index Nutritional risk screening 2002 Patient-generated subjective global assessment Serum inflammatory markers

基金资助:广西医疗卫生适宜技术开发与推广应用项目(S2021096)

通讯作者: 吴向华,电子邮箱:wuzhuone@ 163.com

引用本文:

1谭明浩,2黄道来,1朱冠宇,1文波,1韦世壮,1胡朝镇,2吴向华. 胃癌患者血浆维生素 C 水平与营养及炎症指标的相关性研究[J]. 肿瘤代谢与营养电子杂志, 2025, 12(3): 367-372.
1Tan Minghao,2Huang Daolai,1Zhu Guanyu,1Wen Bo,1Wei Shizhuang,1Hu Chaozhen,2Wu Xianghua. A correlational study on the relationship between serum vitamin C levels and nutritional and inflammatory markers in gastric cancer patients. Electron J Metab Nutr Cancer, 2025, 12(3): 367-372.