目的 针对晚期肺癌化疗患者，探索化疗后骨骼肌减少与化疗不良反应发生率以及化疗疗效相关性。方法 连续 选择 35 例晚期肺癌、接受含铂两药化疗患者，采用人体成分分析仪测量骨骼肌重量，应用 PG-SGA 量表进行营养评估。 分析化疗 2 周期后，患者营养状况变化、并发症发生以及疗效评价等指标，并对比骨骼肌下降＞ 2% 患者（下降组）与骨 骼肌下降≤ 2% 患者（对照组）相关指标及预后的差异。结果 相比于化疗前，对照组患者 2 周期化疗后 PG-SGA 评分显著 降低（5.55±4.01 vs 3.25±2.84，P ＜ 0.05）、前白蛋白显著升高 [（23.62±5.53）g/L vs（27.45±5.26）g/L，P ＜ 0.05]；下降 组患者 2 周期化疗后血红蛋白显著降低 [（128.93±14.14）g/L vs（112.53±10.47）g/L，P ＜ 0.05]。比较两组患者不良反应 及疗效评价情况，结果发现：相比于对照组患者，下降组患者Ⅰ度贫血发生率显著增高（35% vs 66%，P ＜ 0.05）、Ⅱ~Ⅲ 级消化道反应发生率显著升高（35% vs 66%，P ＜ 0.05）；此外，下降组 PR 发生率显著降低（35% vs 13.3%，P ＜ 0.05）、 PD 发生率显著升高（5% vs 20%，P ＜ 0.05）。结论 晚期肺癌患者化疗 2 周期骨骼肌减少＞ 2% 与不良反应发生率紧密关系， 且与预后相关，提示骨骼肌减少＞ 2% 可能作为一个预测化疗不良反应及预后指标。

Objective To evaluate the correlation between the skeletal muscle loss with the toxicity and efficacy in advanced lung cancer patients. Methods 35 advanced lung cancer patients treated with platinum-based doublet chemotherapy were included in this study. Skeletal muscle mass was measured by the human body composition analyzer. And nutritional status of patients were assessed by the scored patient-generated subjective global assessment (PG-SGA). After 2 cycles chemotherapy, the change of nutritional status, incidence of complications, and prognosis were compared between the decrease group (skeletal muscle loss>2%) and the control group (skeletal muscle loss≤2%). Results Compared with before treatment, patients in the control group had significantly lower PG-SGA scores (5.55±4.01 vs 3.25±2.84, P<0.05) and significantly higher prealbumin levels [(23.62±5.53)g/L vs (27.45±5.26g/L, P<0.05] after 2 cycles of chemotherapy. Besides, we found that patients in the decrease group had significantly higher incidence of I degree anemia (35% vs 66%, P<0.05), II-III grade gastrointestinal reaction (35% vs 66%, P<0.05) and PD (5% vs 20%, P<0.05), and significantly lower incidence of PR (35% vs 13.3%, P<0.05) than in the control group. Conclusions The skeletal muscle loss>2% during chemotherapy could influence the incidence of side effects and efficacy, suggesting that it may serve as a predictor of side effects and prognosis of chemotherapy