目的分析乳腺癌术后化疗患者营养不良风险的影响因素，并根据分析结果构建列线图模型。方法选取2019年7月 至2021年7月扬州大学附属医院收治的231例乳腺癌术后化疗患者的相关资料，以体质指数（BMI）<18.5 kg/m2及营养风险筛查 2002（NRS 2002）评分≥3分作为判断营养不良的标准，将其分为营养不良组（65例）及营养正常组（166例）。以多因素Logistic回 归分析乳腺癌术后化疗患者营养不良风险的影响因素，并根据分析结果构建列线图预测模型，再以受试者操作特征曲线（ROC曲 线）的曲线下面积及H‐L拟合度曲线评估该模型的有效性及区分度。通过决策曲线分析（DCA）评估该模型的预测价值。结果 本研究中65例患者出现营养不良，占比28.14%。两组患者年龄、辅助放疗、肝功能损害、化疗药物相对剂量强度、口腔黏膜炎、消 化道反应（便秘和腹胀）比较，差异均有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，年龄≥60岁、有辅助放疗、化疗 药物相对剂量强度为85%～100%、有消化道反应为乳腺癌术后化疗患者发生营养不良的独立危险因素（P<0.05）。根据多因素 Logistic回归分析结果构建乳腺癌术后化疗患者发生营养不良的列线图预测模型并给予评估，ROC曲线下面积为0.824，敏感度 为73.8%，特异度为96.0%。H‐L拟合度曲线结果显示，χ2=7.241，P=0.412。结论年龄≥60岁、有辅助放疗、化疗药物相对剂量强 度为85%～100%、有消化道反应为乳腺癌术后化疗患者发生营养不良的独立危险因素，所构建的列线图预测模型具有较好的预 测价值，能够作为乳腺癌术后化疗患者筛选营养不良发生风险的工具。

Objective To analyze the influencing factors of malnutrition risk in breast cancer patients undergoing chemotherapy and construct a nomogram model based on the analysis results. Method The relevant data of 231 breast cancer patients undergoing chemotherapy in Affiliated Hospital of Yangzhou University were retrospectively analyzed, taking body mass index (BMI) <18.5 kg/m2 and nutritional risk screening 2002 (NRS 2002) score≥3 points as the criteria for judging malnutrition, they are divided into malnutrition group (65 cases) and normal nutrition group (166 cases). The multivariate Logistic regression were used to analyze the influencing factors of malnutrition risk in breast cancer patients undergoing chemotherapy, and a nomogram prediction model was constructed based on the analysis results, then use the area under the receiver operating characteristic (ROC) curve and the H⁃L fit curve to evaluate the effectiveness and discrimination of the model. Use the decision curve analysis (DCA) to evaluate the predictive value of the model. Result 65 patients in this study developed malnutrition, accounting for 28.14%. There were significant differences in age, adjuvant radiotherapy, liver damage, relative dose intensity of chemotherapy drugs, oral mucositis, gastrointestinal reactions (constipation and abdominal distension) between the two groups (P<0.05). Multivariate Logistic regression analysis showed that age ≥60 years old, adjuvant radiotherapy, relative dose intensity of chemotherapeutics of 85%-100%, and gastrointestinal reactions were independent risk factors for malnutrition in patients undergoing chemotherapy after breast cancer surgery (P<0.05). According to the results of multivariate Logistic regression analysis, a nomogram prediction model for malnutrition in patients undergoing chemotherapy after breast cancer surgery was constructed and evaluated, the area under the ROC curve was 0.824, the sensitivity was 73.8%, and the specificity was 96.0%. The H⁃L fit curve results showed that χ2=7.241, P=0.412. Conclusion Age≥60 years old, adjuvant radiotherapy, the relative dose intensity of chemotherapy drugs of 85%-100% and gastrointestinal reactions were independent risk factors for malnutrition in patients undergoing chemotherapy after breast cancer surgery. The constructed nomogram prediction model has good predictive value, and can be used as a tool to screen the risk of malnutrition in patients undergoing chemotherapy after breast cancer surgery