营养风险筛查2002在老年恶性肿瘤患者化疗中的应用研究

目的:了解NRS2002在预估老年肿瘤患者化疗不良反应的潜在作用及相关影响因素，探讨潜在的化疗不良事件的干预措施。方法:2016年7月至2017年2月选择在我院肿瘤内科就诊的149例老年肿瘤化疗患者作为研究对象，入院24 h内完善NRS2002评分及相关病史采集，评估化疗不良反应分级。结果:149例患者中，有营养不良风险（NRS2002评分≥3分）的老年肿瘤患者占43.6%，无营养风险占56.4%，其中年龄、肿瘤类别分布、化疗不良反应分级、WBC、Hb、Scr、UA及血清K+组间差异有统计学意义（P<0.05）。相关性分析结果显示:不良反应分级与NRS2002评分呈正相关性，与WBC、Hb、SCr、UA及K+、Ca2+呈负相关性。线性回归分析提示NRS2002评分的高低与老年肿瘤患者化疗不良反应分级显著正相关，而SCr则是一个负性预测因子。结论:NRS2002可准确预估老年肿瘤化疗患者面临的潜在化疗风险，早期纠正贫血或可缩小老年肿瘤患者的化疗不良反应风险；肾功不全不再是化疗的绝对禁忌证。

The research of nutrition risk screening(NRS)2002 in elderly cancer patients for chemotherapy

Objective:To investigate the relevant influencing factors of NRS2002 in elderly cancer patients for chemotherapy，and to explore the potential interventions for side effects of chemotherapies.Methods:From July 2016 to February 2017，choose 149 cases in our hospital oncology department of elderly cancer patients for chemotherapy as the research.The NRS2002 score and relevant medical history were collected within 24 h of admission，and the side-effect of chemotherapy was evaluated.Results:The 149 patients with a mean age（68.70±3.64）years old consisted of patients with malnutrition risk (43.6%，NRS2002 scores≥3) and no risk of malnutrition (56.4%，NRS2002 scores<3)，in which two groups there were significant differences in age，tumor type distribution，chemotherapy side effect classification，WBC，Hb，Scr，UA and serum K+ level.Correlation analysis results prompted that NRS2002 scores showed positive correlation with side effect，and had a negative correlation with WBC，Hb，SCr，UA，K+ and Ca2+ level.Linear regression analysis showed that side effect classification was positively correlated with NRS2002 in elderly cancer patients for chemotherapy，while negatively correlated with SCr level.Conclusion:NRS2002 could accurately predict the potential side effect in elderly cancer patients for chemotherapy，and to guide the clinical intervention in advance.Hemoglobin may also be one of the predictors for malnutrition risk and chemotherapy side effect in elderly cancer patients.Renal insufficiency is no longer the absolute contraindication of chemotherapy.