1Department of General Diseases/Derpartment of Clinical Nutrition， Cancer Hospital of Huanxing Chaoyang District Beijing， Beijing 100122，China;2Department of General Diseases， National Cancer Center/Cancer Hospital，Chinese Academy of Medical Sciences and Peking Union Medical College，Beijing 100021，China
摘要目的 探讨基于肿瘤营养诊疗系统的个性化营养诊疗在晚期肿瘤化疗患者中的应用价值。方法 选取2019年1月至6月于北京市朝阳区桓兴肿瘤医院新入院的晚期肿瘤化疗患者作为研究对象，所有患者新入院时采用营养风险筛查量表2002进行营养风险筛查，对于存在营养风险的102例患者（NRS 2002≥3分）采用信封法将患者随机分为对照组（n=51）和观察组（n=51）。对照组患者由营养支持小组进行全程营养管理，观察组患者采用肿瘤营养诊疗系统进行个性化营养诊疗。比较两组患者两个周期化疗前后营养状况变化及化疗不良反应发生情况。结果 两个周期化疗后，两组患者体重、肌肉量、四肢骨骼肌指数均保持稳定，与化疗前相比均未有显著性差异（P>0.05）。对照组患者相比于化疗前，血红蛋白［（99.17±12.54）g/L vs （115.26±13.14）g/L］、白蛋白［（34.2±2.33）g/L vs （37.8±2.16）g/L］和前白蛋白［（19.48±3.02）mg/dl vs （26.14±3.21）mg/dl］水平显著提升，差异均有统计学意义（P<0.05）；观察组患者相比于化疗前，血红蛋白［（110.08±15.74）g/L vs （122.91±23.08）g/L］、白蛋白［（37.20±3.18）g/L vs （42.01±5.73）g/L］和前白蛋白［（24.13±2.56）mg/dl vs （29.14±3.74）mg/dl］水平显著提升，差异均有统计学意义（P<0.05）。此外，两组患者出现骨髓抑制（5.9% vs 3.9%）、白细胞减少（5.9% vs 7.8%），以及消化道反应（15.7 vs 19.6%）的情况均没有显著性差异（P>0.05）。结论 基于肿瘤营养诊疗系统的个性化营养诊疗与营养支持小组有助于维持晚期肿瘤患者在两个周期化疗过程中的营养状况，增加化疗耐受性。
Abstract：To explore the application of individualized nutrition diagnosis and intervention based on cancer nutrition diagnosis and intervention system in patients with advanced cancer by chemotherapy. Methods All patients admitted to the hospital from January to June 2019 were screened by nutrition risk screening 2002(NRS 2002). One hundred and two patients with nutritional risk (NRS 2002≥3) were screened， which were randomly divided into the control group (n=51) and the observation group (n=51).The patients in the control group were managed by the nutrition support team， while the patients in the observation group were treated by the cancer nutrition diagnosis and intervention system. The changes of nutritional status between the two groups were compared before and after two cycles of chemotherapy， and the side effects of chemotherapy. Results After two cycles of chemotherapy， the body weight， muscle mass and appendicular skeletal muscle index of the two groups remained stable， and there was no significant difference compared with that before chemotherapy (P>0.05). In the control group， compared with those before chemotherapy， the levels of hemoglobin ［(99.17±12.54)g/L vs (115.26±13.14)g/L］， albumin ［(34.20±2.33)g/L vs (37.80±2.16)g/L］ and prealbumin ［(19.48±3.02)mg/dl vs (26.14 ±3.21)mg/dl］ were significantly increased (P<0.05).Similarly， in the observation group， compared with before chemotherapy， the levels of hemoglobin ［(110.08±15.74)g/L vs (122.91±23.08)g/L］， albumin ［(37.20±3.18)g/L vs (42.01±5.73)g/L］ and prealbumin ［(24.13±2.56）mg/dl vs （29.14±3.74）mg/dl］ were significantly increased (P<0.05).In addition， there were no significant differences in bone marrow suppression (5.9% vs 3.9%)， leukopenia (5.9% vs 7.8%) and digestive tract reaction (15.7 vs 19.6%) between the two groups (P>0.05).Conclusion Individualized nutrition diagnosis and intervention by cancer nutrition diagnosis and intervention system and nutrition support team can help patients with advanced cancer maintain their nutritional status during two cycles of chemotherapy and increase their tolerance to chemotherapy.
1姚克青，1王甦，1陈爽，1孙延滕，1刘清扬，1陈涛，1刘雪辉，2丛明华. 个性化营养诊疗在晚期肿瘤患者中的应用研究[J]. 肿瘤代谢与营养电子杂志, 2019, 6(3): 305-309.
1YAO Ke-qing， 1WANG Su， 1CHEN Shuang， 1SUN Yan-teng， 1LIU Qing-yang， 1CHEN Tao，1LIU Xue-hui， 2CONG Ming-hua. Application of individualized nutrition diagnosis and intervention in patients with advanced cancer. Electron J Metab Nutr Cancer, 2019, 6(3): 305-309.
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