乳腺疾病患者营养状况的现状调查

目的调查乳腺疾病患者营养状况的现状,探讨患者体质量与乳腺癌发生的关系,为预防和筛选乳腺癌提供循证依据。方法便利抽样法选取2012年6-11月在上海交通大学医学院附属瑞金医院乳腺疾病诊治中心住院治疗的1187例患者为研究对象,采用营养风险筛查工具(nutritional risk screening-2002,NRS-2002)对患者的营养状况进行调查,记录其实验室检查指标,并计算体质量指数(body mass index,BMI);随访记录患者住院天数、住院费用及乳腺癌患者的临床分期。结果1187例乳腺疾病患者中有乳腺癌676例(56.95%)和乳腺良性疾病511例(43.05%)。乳腺良性疾病患者中有营养风险患者的比例要高于乳腺癌患者,差异有统计学意义(P0.05)。乳腺癌者中体质量超过正常者的比例要高于乳腺良性疾病患者,差异有统计学意义(P0.05)。乳腺癌患者的白蛋白水平、淋巴细胞计数明显低于乳腺良性疾病患者,而乳腺癌患者的前白蛋白水平却高于乳腺良性疾病患者,差异均有统计学意义(均P0.05)。乳腺癌患者中以临床Ⅰ期(33.38%)和Ⅱ期(53.06%)患者占多数;不同BMI组患者在其临床分期上的差异有统计学意义(P0.05)。结论乳腺癌患者中体质量高于正常者占多数,且超重或肥胖与乳腺癌的发生有一定联系。

Current Status Investigation of Nutritional Status of Patients with Breast Diseases

Objective To assess the nutritional status of patients with breast diseases,and to further analyze and discuss the relationship between weight and breast cancer occurrence and provide evidence-based basis for breast cancer prevention and screening.Methods Nutritional risk screening-2002（NRS-2002）;body mass index（BMI）and laboratory results were used to investigate the nutritional status of 1187 patients with breast disease selected by convenience sampling.The laboratory results,BMI,in-hospital days,expenditure and clinical staging were also recorded.Results Among 1187 patients,676cases（56.95%）had breast cancer and 511cases（43.05%）were the benign breast disease.Higher nutritional risks were found in benign breast disease patients compared with the breast cancer patients（P〈0.05）;Breast cancer patients had the higher proportion of overweight rate than benign breast disease patients and the difference was statistically significant（P〈0.05）;The albumin level,lymphocyte count of breast cancer patients were significant lower than benign breast disease patients,while the prealbumin level of cancer patients were higher than benign breast disease patients and the difference was statistically significant（all P〈0.05）;The majority patients in this study were in stageⅠ（33.38%）and stageⅡ（53.06%）.The clinical stages among different BMI groups were statistically different（P〈0.05）.Conclusion The incidence of overweight in breast cancer patients was above normal.Overweight and obesity were related to breast cancer incidence.