摘要
目的探讨非优势手握力在消化道肿瘤患者入院时基线营养风险筛查的价值及对化疗不良反应的影响。方法选取2017年9月至2021年10月就诊于北部战区总医院肿瘤科的304例消化道肿瘤患者为研究对象,收集患者临床资料,分析其与手握力的关系;根据是否存在营养风险,绘制特异性受试者工作特征曲线(ROC),计算男女手握力最佳截点进行握力分组,比较两组之间临床及血液学指标之间的差异及患者不良反应的发生情况。结果手握力在性别、年龄、NRS2002评分及PG-SGA评分分组间差异有统计学意义(P<0.05)。男性患者手握力与体质量、BMI、前白蛋白、白蛋白、总蛋白计数、KPS评分呈正相关,女性患者手握力与体质量、BMI、前白蛋白、白蛋白、KPS评分呈正相关,男女性患者均与NRS2002、PG-SGA呈负相关。男性、女性握力分别为30.125 kg和19.10 kg时约登指数最大,取两数值为男女握力最佳截点,将患者分为正常握力、低握力两组,两组之间在性别、年龄、BMI、体质量、前白蛋白、白蛋白、总蛋白计数、NRS2002、PG-SGA、KPS评分之间差异有统计学意义(P<0.05)。多元线性回归分析显示,性别、年龄、白蛋白计数、NRS2002、PG-SGA、KPS评分是影响患者手握力的主要因素。在化疗相关不良反应发生上差异无统计学意义(P>0.05)。结论手握力作为简单易得指标可作为患者入院时营养风险筛查评估工具,低握力患者应进一步评估营养状况,尽早采取干预措施。
Objective To explore the non-dominant hand grip strength in digestive tract cancer patients in hospital when baseline value of nutritional risk screening and impact of adverse reactions to chemotherapy. Methods From September 2017 and October 2021, 304 cases of digestive tract cancer patients were selected as research object in northern war zone general hospital of oncology. Clinical data were collected, and its relationship with hand grip strength was analyzed. According to existence of nutritional risk, gender specificity of receiver-operating characteristic curve(ROC)was draw. The best cutoff of point of men and women hand grip strength to group. Differences in clinical, hematology indexes and occurrence of adverse reactions in patients were compared. Results There were significant differences in hand grip strength in gender, age, NRS2002 and PG-SGA score(P<0.05). Male patients’ hand grip strength was positively correlated with body mass, BMI, albumin, total protein, albumin counting and KPS score. Hand grip strength of female was positively correlated with body weight, BMI, prealbumin, albumin, and KPS score. Both male and female were negatively correlated with NRS2002 and PG-SGA. Youden index was the largest when men and women grip strength were 30.125 kg and 19.10 kg, respectively. Taking two values as best cut-off point, patients were divided into two groups of normal and low grip strength.There were significant differences in gender, age, BMI, body mass, albumin, total protein, albumin before counting, NRS2002, PG-SGA and KPS score(P<0.05). There was no difference in the occurrence of chemotherapy-related adverse reactions(P>0.05). Multiple linear regression analysis showed that gender, age, albumin count, NRS2002, PG-SGA, KPS score are the main factors influencing the patients with hand grip strength. Conclusion Hand grip strength, as a simple and accessible indicator, could be used as a nutritional risk screening assessment tool on admission. Patients with low grip strength should further evaluate their nutritional status and intervention as soon as possible.
作者
李宝磊
王超云
王美玲
杜成
郑振东
Li Baolei;Wang Chaoyun;Wang Meiling(Jinzhou Medical University Graduate School,Jinzhou,Liaoning 121001;Department of Oncology,General Hospital of Northern Theater Command,Shenyang,Liaoning 110016,China)
出处
《四川医学》
CAS
2022年第2期175-181,共7页
Sichuan Medical Journal
关键词
手握力
消化道肿瘤
营养风险
化疗
不良反应
hand grip strength
digestive tract tumor
nutritional risk
chemotherapy
adverse reactions
