恶性肿瘤住院患者肌肉减少症的调查及影响因素分析

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摘要目的调查恶性肿瘤住院患者肌肉减少症的发生情况,分析其相关影响因素,并比较有无肌肉减少症的患者之间人体成分、血清学指标及生活质量的差异,为改善患者预后提供数据。方法收集 321 例恶性肿瘤住院患者,利用多频生物电阻抗分析仪对患者进行人体成分测量,依据亚洲肌肉减少症工作组(AWGS)诊断标准进行肌肉减少症诊断,并分为肌肉减少症组和无肌肉减少症组;营养状况评估采用患者主观整体评估( PG-SGA),全身炎症反应评价采用改良格拉斯哥预后评分 (mGPS),生活质量评估采用欧洲生活质量协作组癌症核心量表(QLQ-C30)。采用单因素及多因素 Logistic 回归分析影响患者发生肌肉减少症的因素。采用 t 检验和秩和检验比较两组体成分、血清学指标及生活质量的组间差异。结果本研究共有 102 例患者诊断为肌肉减少症,发病率为 31. 78%;结果显示患者在不同 PG-SGA、体质指数(BMI)、mGPS 分组中肌肉减少症的发病率均有统计学差异(P<0. 05),且 BMI 是影响其发病率的独立因素。肌肉减少症患者各体成分量及血红蛋白、白蛋白、甘油三酯低于无肌肉减少症患者,而细胞外水分比率高于无肌肉减少症患者;在生活质量中功能领域、症状领域评分低于无肌肉减少症患者,便秘、食欲减退评分高于无肌肉减少症患者,差异有统计学意义(P<0. 05)。结论恶性肿瘤住院患者肌肉减少症的发生率与 PG-SGA、BMI、mGPS 有关,其中 BMI 是影响发生率的独立因素;肌肉减少症导致患者各体成分量降低、营养状况差、全身炎症反应评分高、相位角水平低、生活质量差。

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关键词 ：恶性肿瘤, 肌肉减少症, 人体成分, 营养状况, 全身炎症反应

Abstract：Objective To investigate the occurrence of sarcopenia in hospitalized patients with malignant tumor analyze the related influencing factors and compare the differences in body composition serological indicators and quality of life between the sarcopenia group and the non-sarcopenia group so as to provide clinical data for improving the prognosis of patients. Method A total of 321 hospitalized patients with malignant tumor were collected and their body composition was measured by multi-frequency bioelectrical impedance analyzer. Sarcopenia was diagnosed according to the Asian Sarcopenia Working Group AWGS diagnostic criteria and divided into sarcopenia group and non-sarcopenia group. Nutritional status was assessed by patient subjective global assessment PGSGA systemic inflammatory response was assessed by improved Glasgow outcome score mGPS and quality of life was assessed by the European Quality of Life Collaboration Group cancer core scale QLQ-C30 . Univariate and multivariate Logistic regression were used to analyze the factors affecting the occurrence of sarcopenia. T test and rank sum test were used to compare the differences of body composition serological indexes and quality of life between the two groups. 0. 05 means the difference is statistically significant. Result In this study 102 patients were diagnosed with sarcopenia with an incidence of 31. 78% . The results showed that there were statistically significant differences in the incidence of sarcopenia among different PG-SGA body mass index BMI mGPS groups P< 0. 05 and BMI was an independent factor affecting the incidence of sarcopenia patients with body weight and hemoglobin albumin triglyceride were significantly lower than those without sarcopenia patients while extracellular moisture ratio was higher than those without sarcopenia. The scores of functional domains and symptom domains in quality of life were lower than those in patients without sarcopenia and the scores of constipation and anorexia were higher than those in patients without sarcopenia with statistically significant differences P<0. 05 . Conclusion The incidence of sarcopenia in hospitalized patients with malignant tumors is related to PG-SGA BMI and mGPS and BMI is an independent factor affecting the incidence of sarcopenia. Sarcopenia results in low body weight poor nutritional status high systemic inflammatory response score low phase angle level and poor quality of life.

收稿日期: 2022-02-16

基金资助:中国保健医学研究会合作项目 HZ202102 2020 年政府资助临床医学优秀人才培养项目 LS202002

通讯作者: 李增宁电子邮箱 lizengning@ 126. com

引用本文:

1,2张玲玲,1,3郑峥,1何丽,1,3李娜,1,3安永辉,2,3李增宁. 恶性肿瘤住院患者肌肉减少症的调查及影响因素分析[J]. 肿瘤代谢与营养电子杂志, 2022, 9(5): 645-651.
1 2Zhang Lingling,1 3Zheng Zheng,1He Li,1 3Li Na,1 3An Yonghui,2 3Li Zengning. Investigation and analysis of influencing factors of sarcopenia in hospitalized patients with malignant tumors. Electron J Metab Nutr Cancer, 2022, 9(5): 645-651.