目的 分析结直肠癌患者营养相关症状对营养状态的影响及其与全球营养不良领导倡议（GLIM）和生活质量的相关性。 方法 本研究共纳入2013年6月至2018年12月多中心连续招募的结直肠癌患者2063例，进行营养不良诊断和生活质量评估，通过 Logistic回归分析描述营养相关症状对营养状态的影响，并通过Spearman相关性分析营养相关症状与GLIM和生活质量的相关性。 结果 共有875例（42.4%）患者至少有1种营养相关症状，发生率最高的是食欲不振（14.5%），948例（45.5%）患者为营养不良。QLQ⁃C30 总分中位数为66.7分。Spearman相关性分析显示，除口腔溃疡外，食欲不振（r=0.246，P<0.001）、恶心（r=0.137，P<0.001）、呕吐（r= 0.154，P<0.001）、便秘（r=0.124，P<0.001）、口干（r=0.138，P<0.001）、饱腹感（r=0.150，P<0.001）、疼痛（r=0.175，P<0.001）、营养相关症 状评分（r=0.337，P<0.001）与全球营养不良领导倡议（GLIM）标准诊断的营养不良均存在相关性；腹泻（r=0.072，P=0.001）、味觉改变 （r=0.088，P<0.001）、嗅觉改变（r=0.070，P=0.001）、吞咽困难（r=0.049，P=0.025）与GLIM标准诊断的营养不良的相关性尽管有统计 学意义，但相关性较低，QLQ⁃C30总分与所有营养相关症状（除腹泻外）均相关（食欲不振：r=0.309，P<0.001；恶心：r=0.209，P<0.001； 呕吐：r=0.189，P<0.001；便秘：r=0.138，P<0.001；口腔溃疡：r=0.077，P<0.001；口干：r=0.157，P<0.001；味觉改变：r=0.157，P<0.001；嗅 觉改变：r=0.119，P=0.001；吞咽困难：r=0.104，P=0.025；饱腹感：r=0.115，P<0.001；疼痛：r=0.154，P<0.001）。对年龄、患者类型、分期、 营养治疗进行调整以后，食欲不振、呕吐、便秘、腹泻、口干、饱腹感和疼痛是GLIM标准诊断的营养不良的独立危险因素（食欲不振： HR=3.152，95%CI=2.335~4.255，P<0.001；呕吐：HR=2.877，95%CI=1.648~5.023，P<0.001；便秘：HR=1.796，95%CI=1.283~2.516，P= 0.001；腹泻：HR=1.549，95%CI=1.096~2.190，P=0.013；口干：HR=2.252，95%CI=1.454~3.488，P<0.001；饱腹感：HR=3.317，95%CI=2.102~ 5.235，P<0.001；疼痛：HR=2.346，95%CI=1.628~3.379，P<0.001）。 结论 结直肠癌患者营养相关症状发生率较高，并与营养状态与 生活质量相关，尽早评估其发生状况有利于采取相应治疗改善患者的营养状态和生活质量。

Objective To evaluate the impact of nutrition⁃related symptoms on the nutritional status and its correlation with Global Leadership Initiative on Malnutrition (GLIM) and quality of life. Method A total of 2063 patients with colorectal cancer re⁃ cruited in multicenters from June 2013 to December 2018 were included in this study, all of them completed malnutrition diagnosis and evaluation of quality of life. Logistic regression analysis was used to evaluate the impact of nutrition⁃related symptoms on nutri⁃ tional status, and Spearman correlation analysis was used to assess the correlation between nutrition⁃related symptoms and GLIM, quality of life. Result A total of 875 patients (42.4%) had at least one nutrition⁃related symptom, and the highest incidence was no appetite (14.5%), 948 patients (45.5%) were malnourished. The median of QLQ⁃C30 score of 66.7.The results of Spearman correla⁃ tion analysis showed that except for mouth sores, no appetite (r=0.246, P<0.001), nausea (r=0.137, P<0.001), vomiting(r=0.154, P< 0.001), constipation (r=0.124, P<0.001), dry mouth (r=0.138, P<0.001), feel full (r=0.150, P<0.001), pain (r=0.175, P<0.001), the score of nutrition-related symptoms (r=0.337, P<0.001) were correlated with malnutrition according to GLIM criteria. The associa⁃ tion between malnutrition diagnosed by GLIM criteria and diarrhea (r=0.072, P=0.001), change in taste (r=0.088, P<0.001), change in smell (r=0.070, P=0.001), problems swallowing (r=0.049, P=0.025) was low, although statistically significant. The QLQ⁃C30 score was correlated with nutrition⁃related symptoms (except diarrhea) (no appetite:r=0.309, P<0.001; nause: r=0.209, P<0.001; vomiting: r=0.189, P<0.001; constipation: r=0.138, P<0.001; mouth sores: r=0.077, P<0.001; dry mouth: r=0.157, P<0.001; change in taste: r=0.157, P<0.001; change in smell: r=0.119, P=0.001; problems swallowing: r=0.104, P=0.025; feel full: r=0.115, P<0.001; pain: r=0.154, P<0.001). No appetite, vomiting, constipation, diarrhea, dry mouth, feel full and pain were independent risk factors for malnutrition after adjustment for age, type of cancer, stage, organ metastasis, and nutritional treatment (no appetite: HR=3.152, 95%CI=2.335-4.255, P<0.001; vomiting: HR=2.877, 95%CI=1.648-5.023, P<0.001; constipation: HR=1.796, 95%CI=1.283-2.516, P=0.001; diarrhea: HR=1.549, 95%CI=1.096-2.190, P=0.013; dry mouth: HR=2.252, 95%CI=1.454-3.488, P<0.001; feel full: HR= 3.317, 95%CI=2.102-5.235, P<0.001; pain: HR=2.346, 95%CI=1.628-3.379, P<0.001). Conclusion The prevalence of nutrition⁃re⁃ lated symptoms in patients with colorectal cancer is high, and it is related to the nutritional status and quality of life. Early assessment of the occurrence of nutrition⁃related symptoms is beneficial to take appropriate treatment to improve the nutritional status and quali⁃ ty of life of patients.