单倍体造血干细胞移植患者移植前后营养状况动态变化

doi:10.16689/j.cnki.cn11－9349/r.2019.04.009

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摘要目的分析单倍体造血干细胞移植患者移植前后不同阶段的营养状况变化，为移植后患者临床营养干预提供依据。方法本研究纳入2015年7月至2017年6月在吉林大学第一医院血液科接受单倍体移植良性和恶性血液病患者47例，采用患者主观整体评估、人体测量和人体成分分析法对患者移植前、移植后30d、移植后90d、移植后180d四个时间点的营养状况进行综合评估分析。结果患者的体重、体质指数、非脂肪组织、左小腿周径、上臂中点周径等营养指标均在移植后30d开始下降，而脂肪组织在移植后30d有所上升但无统计学意义，移植后180d部分指标开始恢复，但仍旧低于移植前（均P<0.05）。患者主观整体评估显示，移植后30d存在营养不良患者高达95.56%，移植后180d有所恢复但依旧高于移植前（P<0.05）。移植早期男女体重、非脂肪变化存在差异（P<0.05），尤其是移植后30d男性体重丢失比例远大于女性，男性比女性可能更容易出现营养问题。结论单倍体移植患者移植后均可出现不同程度的营养不良，而通过患者主观整体评估、人体成分分析两种方法联合对患者进行营养评估可能更加准确和全面。

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	贾艳雪
	谭业辉
	高素君
	李薇
	彭昳

关键词 ：血液病, 单倍体造血干细胞移植, 营养评估, 人体成分分析

Abstract：ObjectiveTo explore the nutritional status of patients underwent haploid hematopoietic stem cell transplantation （HSCT） before and after transplantation, and to provide evidence for clinical nutritional intervention among post transplantation patients. Methods Forty-seven patients with hematological diseases received haploidentical allo-HSCT from July 2015 to June 2017 in the First Hospital of Jilin University were enrolled in present study. The patient-generated subjective global assessment （PG-SGA） and human component analysis were assessed before transplantation and 30, 90,180 days after transplantation respectively. ResultsThe body weight, body mass index （BMI）, fat-free mass, peripheral diameter of the left leg and mid-arm circumference decreased significantly at 30 days after transplantation, while fat mass increased but showed no statistical significance. Some indexes began to recover at 180 days after transplantation, but still lower than those before transplantation （all P<0.05）. According to the PG-SGA evaluation, malnutrition was as high as 95.56% in patients 30 days after transplantation, and recovered at 180 days after transplantation but still higher than those before transplantation （P<0.05）. In the early stage of transplantation, there were differences in weight and fat-free mass changes between men and women （P<0.05）. In particular, the proportion of weight loss in men at 30 days after transplantation was much higher than that in women, and men were more likely to have nutritional problems than women. ConclusionMalnutrition may occur in all patients after haploidentical allo-HSCT, and the nutritional assessment of the patients was more accurate and comprehensive by PG-SGA and human composition analysis.

Key words： Hematological diseases Haploid hematopoietic stem cell transplantation Nutritional assessment Human component analysis

基金资助:吉林省发改委课题（2016C051-1）

通讯作者: 彭昳，电子邮箱：2602838069@qq.com

引用本文:

贾艳雪，谭业辉，高素君，李薇，彭昳. 单倍体造血干细胞移植患者移植前后营养状况动态变化[J]. 肿瘤代谢与营养电子杂志, 2019, 6(4): 436-441.
JIA Yan-xue, TAN Ye-hui, GAO Su-jun, LI Wei, PENG Yi. Changes of nutritional status in hematological patients before and after haploid hematopoietic stem cell transplantation. Electron J Metab Nutr Cancer, 2019, 6(4): 436-441.

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