恶性肿瘤病人营养不良评价方法的比较
作者：朱步东 刘淑俊 李淑芳 任小琼
单位：朱步东 刘淑俊 李淑芳(北京医科大学临床肿瘤学院 北京肿瘤研究所)；任小琼(甘肃省平凉地区医院肿瘤科)
关键词：
中国临床营养杂志000124摘 要：目的比较营养不良指标：体质指数(BMI)、实际体重与理想体重比(%IBW1)和血清白蛋白浓度(Alb)对恶性肿瘤病人营养不良的诊断意义。探讨《中国成年人体质测定标准指南》的实用价值。 方法测定477例恶性肿瘤病人住院时或就诊时的实际体重、身高、血清Alb浓度，询问其健康时的平时体重(UBW)。所有病人无腹水或水肿。根据《中国成年人体质测定标准指南》，查出相应年龄身高段病人的健康理想体重(IBW2)。根据改良Broca公式：IBW2=身高(cm)-105计算出病人健康时的理想体重(IBW2)。BMI=住院或就诊时体重(kg)/[身高(m2)]。实际体重与理想体重比(%IBW1)=(住院或就诊时实际体重/IBW1)×100%。符合下列标准之一者诊断为营养不良：1.IBW1标准：%IBw1标准：BMI<18.5。2.IBW2标准：BMI<20(男性)或BMI<19(女性)。3.%IBW1标准：%IBW1≤90%。4.Alb标准：血清Alb浓度<35g/L。 结果IBW1与健康时的平时体重比较差异无显著性(P=0.684)；并呈显著相关性(r=0.778；P=0.000)。IBW2低于健康时体重或IBW1(P=0.000)。UBW、IBW，、IBW2相互之间均显著相关，r=0.481～0.801，P值均为0.000。%lBW1、BMI2、BMI1和血清Alb浓度四种指标对本组恶性肿瘤病人营养不良的检出率，依次为32.3%、19.0%、11.4%、6.5%，经X2检验后，差异呈非常显著性(P值均为0.000)。%IBW1、BMI2和BMI1三种指标相互之间呈非常显著相关，r值为0.518～0.739，P值均为0.000。所有符合BMI1、BMI2和血清Alb营养不良标准病人的%IBW1值均≤90%。而血清Alb浓度指标，分别与BMI1、BMI2、%IBW1指标之间相关性差，厂分别为0.102、0.112、0.093，P均>0.05。 结论《中国成年人体质测定标准指南》中健康时的理想体重，能代表恶性肿瘤病人健康时的平时体重。%IBW1指标对恶性肿瘤病人营养不良的检出率最高，血清Alb指标最低，恶性肿瘤病人的营养评定应以实际体重与理想体重比为主要指标。《中国成年人体质测定标准指南》具有应用价值。
, 百拇医药
The evaluation of nutritional parameters in cancer patients
ZHU Budong ,PEN Xiaoqong ,LIU Shujun
(School of Oncology, Beijing Medical University and Beijing Institute for Cancer Research, Beijing 100036, China)
Abstract：Objective To evaluate nutritional parameters: body mass index(BMI), the actual body weight/ideal body weight (%IBW1), and serum concentration of albumin (Alb) for diagnosis of malnutrition in cancer patients. To extend the usefulness of China Adult Constitute Standard Guide. Methods The actual body weight, height, and serum concentration of Alb of 477 cancer patients were measured at admission or at outpatient service. Usual body weight (UBW) of cancer patients while healthy was inquired, All the patients tients have no edema and ascites. Ideal body weight(IBW1) were produced from China Adult Constitute Standard Guide. Ideal body weight(IBW2) were resulted from the formula: height(cm)-105. BMI=the actual body weight at admission or at outpatient service (kg)/(height in m)2. %IBW1=the actual body weight/IBW1×100%. The patients with one of the following 4 parameters-%IBW1≤90% ,BMI2<20(for males) or BMI2<19(for females), and serum Alb<35g/L were diagnosed of malnutrition. Results No significant difference between UBW and IBW1 was found (P=0. 684). IBW2 was significantly lower than UBW or IBW1 (P=0.000). Correlation coefficient between UBW and IBWi was 0. 778 (P=0. 000). Highly significant correlation exist between UBW, IBW1 and IBW2 (r=0. 481～0. 801, P=0. 000). In detected rate of % IBW1, BMI1, BMI2 and serum Alb for diagnosis of malnutrition, highly significant difference exist one another. Highly significant correlation exist between % IBW1, BMI1 and BMI2 (r=0. 518～0.739, P=0.000). 32.2% of the cancer patients suffered from malnutrition by % IBW1≤90%; 19.0% by BMI2; 11.4% by BMI1<18.5; 6.5 % by serum Alb. All of the patients with malnutrition by BMI1, or BMI2, or serum Alb were in % IBW≤90%. Serum Alb has no significant correlation with % IBW1, BMI1, or BMI2 (r=0. 093,0. 102,0.112, P>0.05). Conclusions IBW1 can represent usual body weight of the cancer patients while healthy. In term of the efficacy of % IBW1, BMI1, BMI2 and serum Alb for diagnosis of malnutrition in the cancer patients, % IBW is best and highest; serum concentration of Alb is lowest. China Adult Constitute Standard Guide have certainly applicative value., http://www.100md.com
单位：朱步东 刘淑俊 李淑芳(北京医科大学临床肿瘤学院 北京肿瘤研究所)；任小琼(甘肃省平凉地区医院肿瘤科)
关键词：
中国临床营养杂志000124摘 要：目的比较营养不良指标：体质指数(BMI)、实际体重与理想体重比(%IBW1)和血清白蛋白浓度(Alb)对恶性肿瘤病人营养不良的诊断意义。探讨《中国成年人体质测定标准指南》的实用价值。 方法测定477例恶性肿瘤病人住院时或就诊时的实际体重、身高、血清Alb浓度，询问其健康时的平时体重(UBW)。所有病人无腹水或水肿。根据《中国成年人体质测定标准指南》，查出相应年龄身高段病人的健康理想体重(IBW2)。根据改良Broca公式：IBW2=身高(cm)-105计算出病人健康时的理想体重(IBW2)。BMI=住院或就诊时体重(kg)/[身高(m2)]。实际体重与理想体重比(%IBW1)=(住院或就诊时实际体重/IBW1)×100%。符合下列标准之一者诊断为营养不良：1.IBW1标准：%IBw1标准：BMI<18.5。2.IBW2标准：BMI<20(男性)或BMI<19(女性)。3.%IBW1标准：%IBW1≤90%。4.Alb标准：血清Alb浓度<35g/L。 结果IBW1与健康时的平时体重比较差异无显著性(P=0.684)；并呈显著相关性(r=0.778；P=0.000)。IBW2低于健康时体重或IBW1(P=0.000)。UBW、IBW，、IBW2相互之间均显著相关，r=0.481～0.801，P值均为0.000。%lBW1、BMI2、BMI1和血清Alb浓度四种指标对本组恶性肿瘤病人营养不良的检出率，依次为32.3%、19.0%、11.4%、6.5%，经X2检验后，差异呈非常显著性(P值均为0.000)。%IBW1、BMI2和BMI1三种指标相互之间呈非常显著相关，r值为0.518～0.739，P值均为0.000。所有符合BMI1、BMI2和血清Alb营养不良标准病人的%IBW1值均≤90%。而血清Alb浓度指标，分别与BMI1、BMI2、%IBW1指标之间相关性差，厂分别为0.102、0.112、0.093，P均>0.05。 结论《中国成年人体质测定标准指南》中健康时的理想体重，能代表恶性肿瘤病人健康时的平时体重。%IBW1指标对恶性肿瘤病人营养不良的检出率最高，血清Alb指标最低，恶性肿瘤病人的营养评定应以实际体重与理想体重比为主要指标。《中国成年人体质测定标准指南》具有应用价值。
, 百拇医药
The evaluation of nutritional parameters in cancer patients
ZHU Budong ,PEN Xiaoqong ,LIU Shujun
(School of Oncology, Beijing Medical University and Beijing Institute for Cancer Research, Beijing 100036, China)
Abstract：Objective To evaluate nutritional parameters: body mass index(BMI), the actual body weight/ideal body weight (%IBW1), and serum concentration of albumin (Alb) for diagnosis of malnutrition in cancer patients. To extend the usefulness of China Adult Constitute Standard Guide. Methods The actual body weight, height, and serum concentration of Alb of 477 cancer patients were measured at admission or at outpatient service. Usual body weight (UBW) of cancer patients while healthy was inquired, All the patients tients have no edema and ascites. Ideal body weight(IBW1) were produced from China Adult Constitute Standard Guide. Ideal body weight(IBW2) were resulted from the formula: height(cm)-105. BMI=the actual body weight at admission or at outpatient service (kg)/(height in m)2. %IBW1=the actual body weight/IBW1×100%. The patients with one of the following 4 parameters-%IBW1≤90% ,BMI2<20(for males) or BMI2<19(for females), and serum Alb<35g/L were diagnosed of malnutrition. Results No significant difference between UBW and IBW1 was found (P=0. 684). IBW2 was significantly lower than UBW or IBW1 (P=0.000). Correlation coefficient between UBW and IBWi was 0. 778 (P=0. 000). Highly significant correlation exist between UBW, IBW1 and IBW2 (r=0. 481～0. 801, P=0. 000). In detected rate of % IBW1, BMI1, BMI2 and serum Alb for diagnosis of malnutrition, highly significant difference exist one another. Highly significant correlation exist between % IBW1, BMI1 and BMI2 (r=0. 518～0.739, P=0.000). 32.2% of the cancer patients suffered from malnutrition by % IBW1≤90%; 19.0% by BMI2; 11.4% by BMI1<18.5; 6.5 % by serum Alb. All of the patients with malnutrition by BMI1, or BMI2, or serum Alb were in % IBW≤90%. Serum Alb has no significant correlation with % IBW1, BMI1, or BMI2 (r=0. 093,0. 102,0.112, P>0.05). Conclusions IBW1 can represent usual body weight of the cancer patients while healthy. In term of the efficacy of % IBW1, BMI1, BMI2 and serum Alb for diagnosis of malnutrition in the cancer patients, % IBW is best and highest; serum concentration of Alb is lowest. China Adult Constitute Standard Guide have certainly applicative value., http://www.100md.com