胃肠道恶性肿瘤患者的人体成分分析

目的 分析胃肠道肿瘤患者的人体成分，探讨人体成分指标在评估胃肠道肿瘤患者营养状况中的价值。方法 纳入拟行手术治疗的胃肠道恶性肿瘤患者162例，入院行主观综合营养评估（SGA）和生物电阻抗体成分分析。结果 低去脂指数、低骨骼肌指数和细胞外水肿的发生率均为1/4左右，其中20%以上为SGA评为营养良好的患者。体成分指标与SGA评估营养不良的一致性均差，但低脂肪指数与SGA的一致性在男性患者中更好，而低骨骼肌指数与SGA的一致性在女性患者中更好。相位角<4°的患者，评定为低体重指数、低去脂指数、低骨骼肌指数、细胞外水肿、营养不良、重度营养不良和低蛋白血症的特异性高达98%以上。结论 有必要结合人体成分指标来评估胃肠道肿瘤患者的营养状况；人体成分指标在评判营养不良时存在性别差异；相位角＜4°在全面地评定营养不良方面具高特异性。

Body Composition of Patients with Malignant Gastrointestinal Tumor

Objective To analyze the body composition of patients with malignant gastrointestinal tumor and explore the value of body composition analysis in nutrition assessment. Methods We included 162 patients with malignant gastrointestinal tumor admitted for surgery treatment. Subjective global assessment (SGA) was performed for identifying malnutrition and body composition was analyzed by bioelectrical impedance. Results The incidence of low fat free mass index, skeletal muscle index and extracellular overhydration were all about 1/4, among which more than 20% patients were classified as well-nourished by SGA. Poor agreement was found between SGA and body composition indexes. However, low fat mass index was better agreed with SGA in male patients while low skeletal muscle index was better agreed with SGA in female patients. Phase angle <4° had high specificity of 98% for identifying low body mass index, low fat free mass index, low skeletal muscle index, extracellular overhydration, malnutrition, severe malnutrition and hypoalbuminemia. Conclusion Body composition indexes should be analyzed in the assessment of nutrition status of malignant gastrointestinal tumor patients. Gender difference exists in body composition indexes to indentify malnutrition. Phase angle <4° has high specificity for comprehensively indentifying malnutrition.