食管癌患者不同时间段营养状况与氧化应激水平的相关性研究

目的探讨食管癌患者术前1周、术后1周、术后2周机体营养状况与氧化应激水平的相关性,为临床食管癌患者术前、术后分阶段营养支持提供依据。方法对92例食管癌患者在术前1周、术后1周、术后2周分别进行体质指数、上臂中围、上臂肌围、肱三头肌皮褶厚度、总淋巴细胞计数、血清白蛋白营养不良指标监测,同时进行血清中总超氧化物歧化酶、总抗氧化能力、谷胱甘肽过氧化物酶、丙二醛实验室检测,采用Pearson分析患者营养状况与氧化应激水平的相关性。结果患者术前1周营养不良发生率为26.09%,术后1周营养不良的发生率升高至81.52%;术后1周较术前及术后2周营养指标都有变化(P0.05)。术前1周丙二醛与上臂中围、上臂肌围呈显著负相关(P0.01);术后1周丙二醛与体重指数、白蛋白呈负相关(P0.01);术后2周超氧化物歧化酶与体重指数、白蛋白呈正相关(P0.01)。结论食管癌患者术前1周即存在营养不良,术后1周是营养不良和氧化应激发生最为严重的时期,术后2周营养不良状况与氧化应激反应仍低于术前1周,护理工作者应通过积极、有效营养干预,改善患者术后营养状态氧化应激水平。

The correlation between nutrition at different time and the oxidative stress status in patients with esophageal cancer

Objective To investigate the correlation between nutrition levels and the oxidative stress status in patients with esophageal cancer at the 1 st week before surgery,the 1 st week,the 2nd week after surgery,so as to provide reference on nutrition support before and after sugery.Method A total of 92 esophageal cancer patients at the 1 st week before surgery,the 1 st week,the 2nd week after surgery were monitored with nutritional indexes,including body mass index (BMI),mid-arm circum-ference (MAC),triceps skinfold (TSF),total lymphocyte count and serum albumin,superoxide dismutase (SOD),glutathione peroxidase,total antioxidant capacitycad malondialdehyde(MDA) in blood serum.The relationship of the nutrition status and the oxidative stress were analyzed using the Pearson correlation analysis.Results The incidence of malnutrition was 26.09％ at the 1 st weeks before surgery,and increased to 81.52％ at the 1 st week after surgery.There were statistic differences in the nutritional indexes at the 1 st week before surgery and the 2nd week after surgery(P ＜ 0.05).There was a significant negative correlation between MDA and MAC,MAC at the 1 st week before surgery (P ＜ 0.01).There was a significant negative correlation between MDA and BMI,serum albumin at the 1st week after surgery (P ＜ 0.01).At the 2nd week,SOD was positively correlated with BMI and albumin (P ＜ 0.01).Conclusions Esophageal cancer patients have malnutrition at the 1 st week before surgery.The malnutrition and oxidative stress status are worst in the 1 st week after surgery,and higher than the 2nd week after surgery.Nursing educators should take active and effective nutrition intervention to improve nutritional status in patients with esophageal cancer.