握力对鼻咽癌同步放化疗患者营养风险的诊断价值

doi:10.20047/j.issn1673-7210.2023.02.20

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摘要目的探讨握力在鼻咽癌同步放化疗患者营养风险评估中的诊断价值。方法选取2019年9月至2020年12月在广西医科大学第一附属医院肿瘤科住院的鼻咽癌患者158例。收集患者的一般资料、疾病相关资料、血液指标、握力大小、营养风险评分。患者以营养风险2002（NRS2002）评分进行分组，NRS2002≥3分的患者为营养风险组（65例），NRS2002＜3分的患者为无营养风险组（93例）。logistic回归分析鼻咽癌同步放化疗患者营养风险的影响因素。将鼻咽癌患者握力进行5分位分组，从小到大依次分为最低水平1组（≤22.60 kg）、低水平2组（＞22.60～28.70 kg）、中等水平3组（＞28.70～33.70 kg）、高水平4组（＞33.70～38.90 kg）、最高水平5组（＞38.90 kg），趋势性检验分析握力与营养风险的关系，受试者工作特征（ROC）曲线判断鼻咽癌同步放化疗患者存在营养风险的临界值。结果两组性别、臂围、小腿围、身高、体重、体重指数、血红蛋白、白蛋白、前白蛋白、肌酐、握力比较，差异有统计学意义（P＜0.05）。多因素分析结果显示，肌酐、握力是鼻咽癌患者存在营养风险的影响因素（P＜0.05）。从高水平握力到低水平握力组，随着握力的降低，患者营养风险呈上升趋势，握力预测鼻咽癌同步放化疗患者存在营养风险的ROC曲线下面积均＞0.5，男性握力＜32.0 kg，女性握力＜20.2 kg时可判断存在营养风险。结论握力可作为鼻咽癌同步放化疗患者营养风险的筛查指标。

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	韦洁静1* 卢婷2* 应燕萍3 凌瑛3 黄彪进1

关键词 ：鼻咽癌, 握力, 同步放化疗, 营养风险, 诊断价值

Abstract：Objective To explore the diagnostic value of grip strength in nutritional risk assessment in patients with nasopharyngeal carcinoma undergoing concurrent radiotherapy and chemoradiotherapy. Method A total of 158 patients with nasopharyngeal carcinoma who were hospitalized in the Department of Oncology, the First Affiliated Hospital of Guangxi Medical University from September 2019 to December 2020 were selected. General data, disease-related data, blood indicators, grip strength, and nutritional risk scores were collected. Patients were grouped by nutritional risk screening 2022 (NRS2002), patients with NRS2002 scores ≥3 points were classified into the nutritional risk group (65 cases), and those with NRS2002 < 3 points were classified into the non-nutritional risk group (93 cases). Nutritional risk factors in patients with simultaneous chemoradiotherapy for nasopharyngeal carcinoma were analyzed by logistic regression. The grip strength of patients with nasopharyngeal carcinoma was divided into five groups. From small to large, they were divided into the lowest level group 1 (≤22.60 kg), the low level group 2 (＞22.60 to 28.70 kg), the medium level group 3 (＞28.70 to 33.70 kg), the high level group 4 (＞33.70 to 38.90 kg) and the highest level group 5 (＞38.90 kg). Trend test was used to analyze the relationship between grip strength and nutritional risk, and receiver operating characteristic (ROC) curve was used to determine the critical value of nutritional risk in patients with simultaneous chemoradiotherapy of nasopharyngeal carcinoma. Results There were statistically significant differences in gender, arm circumference, calf circumference, height, body weight, body mass index, hemoglobin, albumin, prealbumin, creatinine, and grip strength between the two groups (P＜0.05). The results of multivariate analysis showed that creatinine and grip strength were the factors affecting nutritional risk in nasopharyngeal carcinoma patients (P＜0.05). From the high level of grip strength to the low level of grip strength group, the nutritional risk of patients showed an upward trend with the decrease of grip strength. The area under ROC curve of grip strength predicting nutritional risk in patients with concurrent radiotherapy and chemotherapy of nasopharyngeal cancer was ＞0.5. The presence of nutritional risk could be judged when the grip strength of male was <32.0 kg and that of female was <20.2 kg. Conclusion Grip strength can be used as a screening index for nutritional risk in patients with nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy.

Key words： Nasopharyngeal carcinoma Grip strength Concurrent radiotherapy and chemoradiotherapy Nutritional risk Diagnostic value

基金资助:国家自然科学基金资助项目（81860032）；
广西自然科学基金资助项目（2018GXNSFAA050081）。

作者简介: *具有同等贡献卢婷（1995-），女，硕士，主要从事肿瘤护理相关研究。

引用本文:

韦洁静1* 卢婷2* 应燕萍3 凌瑛3 黄彪进1. 握力对鼻咽癌同步放化疗患者营养风险的诊断价值[J]. 中国医药导报, 2023, 20(2): 88-92.
WEI Jiejing1* LU Ting2* YING Yanping3 LING Ying3 HUANG Biaojin1. Diagnostic value of grip strength for the nutritional risk of patients with nasopharyngeal carcinoma with concurrent radiotherapy and chemotherapy. 中国医药导报, 2023, 20(2): 88-92.

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