食管癌患者化疗前后9种维生素和其他相关血液指标变化及意义

目的研究食管癌患者化疗前后血清中9种维生素浓度和血液指标变化及临床意义。方法选取2018年2月至2020年3月解放军总医院收治的食管癌患者,对所有患者进行血清维生素(A、D、E、B_(9)、B_(12)、B_(1)、C、B_(2)、B_(6))浓度、血红蛋白、血清白蛋白和电解质测定,比较两周期化疗前后维生素浓度及血液指标变化,并分析化疗前后9种维生素和体质指数变化的相关性。结果139例食管癌患者存在不同程度的维生素A、维生素D、维生素C和维生素B_(2)缺乏,化疗前维生素B_(2)缺乏比例最高,化疗后维生素C缺乏最多。化疗前后维生素A、维生素C、维生素B_(6)的浓度差异有统计学意义(P<0.05)。食管癌患者化疗后血红蛋白及血清白蛋白浓度均较化疗前下降(P<0.05),同时存在不同程度的体质量丢失。食管癌患者化疗前后血清维生素A、维生素C、维生素B_(6)的浓度变化与体质指数变化存在相关性(P<0.05)。结论食管癌患者化疗期间以维生素A、维生素D、维生素C和维生素B_(2)缺乏为主,化疗后体质量丢失、贫血、低蛋白血症患者比例增加,补充维生素和优质蛋白质,纠正贫血,有助于改善患者营养状况。

The change and its significance of the nine vitamins concentration and hematological parameters in patients with esophageal cancer before and after chemotherapy

Objective To investigate the changes in serum concentrations of nine vitamins and blood indexes during chemotherapy for esophageal cancer and explore their clinical values.Methods Patients who underwent chemotherapy for esophageal cancer in our center from February 2018 to March 2020 were enrolled in this study.The concentrations of serum vitamins(A,D,E,B₉,B₁₂,B₁,C,B₂,B₆),hemoglobin,serum albumin and electrolytes were measured.The changes and differences of vitamin concentration and blood indexes before and after 2 cycles of chemotherapy were compared.The correlation between 9 vitamins and body mass index before and after chemotherapy was analyzed.Results There were different degrees of Vitamin A,vitamin D,vitamin C and vitamin B₂ deficiency in 139 patients with esophageal cancer,the highest proportion of vitamin B₂ deficiency before chemotherapy and the most vitamin C deficiency after chemotherapy.There were significant differences in the concentrations of vitamin A,vitamin C and vitamin B₆ before and after chemotherapy(P<0.05).The concentrations of hemoglobin and serum albumin in patients with esophageal cancer after chemotherapy were lower than those before chemotherapy(P<0.05).There were different degrees of weight loss concurrently.The changes of serum vitamin A,vitamin C and vitamin B₆ in patients with esophageal cancer before and after chemotherapy were correlated with the changes of body mass index(P<0.05).Conclusion The patients with esophageal cancer have mainly deficient in vitamin A,vitamin D,vitamin C and vitamin B₂ during chemotherapy.The proportion of patients with weight loss,anemia and hypoproteinemia increased after chemotherapy.Supplementation of vitamins and high quality protein,correction of anemia are helpful to improve the nutritional status of patients,the tolerance and therapeutic effect of chemotherapy.