探讨老年肝癌介入化疗栓塞(TACE)患者营养不良与外周血炎性指标的相关性及相关预测模型的建立。 方法 选取 2020 年 5 月至 2022 年 5 月期间青岛大学附属青岛市中心医院收治的 120 例老年肝癌患者为研究对象,均行 TACE 术治 疗。 术后患者整体营养评估量表评估患者营养状况,分为成营养不良组(评分 2~ 21 分)和非营养不良组(评分 0~ 1 分)。 比较 两组外周血炎症指标[白细胞介素-6(IL-6)、IL-8、C 反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]。 采用 Spearman 相关系数分 析老年 TACE 患者营养不良与上述指标的相关性。 收集两组患者的相关资料,采用 Logistic 回归模型筛选老年 TACE 患者术后 营养不良的危险因素,建立预测模型,绘制受试者操作特征(ROC)曲线分析预测模型的临床应用价值。 结果 120 例患者 TACE 术后营养不良者共 76 例。 营养不良组血清 IL-6、IL-8、CRP、TNF-α 均高于非营养不良组(P<0. 05)。 老年 TACE 患者营养不良 与外周血炎性指标 IL-6、IL-8、CRP、TNF-α 均呈正相关性(P<0. 05)。 营养不良组 BMI、术前营养治疗占比、ALB、PAB 均低于非 营养不良组,贫血、乙型病毒性肝炎、焦虑抑郁、癌因性疲乏占比高于非营养不良组(P<0. 05)。 IL-6、IL-8、CRP、TNF-α 升高、贫 血、术前未行营养支持、焦虑抑郁、癌因性疲乏、ALB 降低均是老年 TACE 患者营养不良的独立危险因素(P<0. 05)。 风险预测模 型预测老年 TACE 患者营养不良的 AUC 值为 0. 899,灵敏度和特异度分别为 88. 4%和 87. 1%。 结论 老年肝癌 TACE 患者营养不 良与外周血炎性指标呈正相关性,建立的风险预测模型可以用于预测老年肝癌 TACE 患者术后营养不良发生风险。

To investigate the correlation between malnutrition and peripheral blood inflammatory indexes in elderly patients with liver cancer with interventional chemoembolization TACE and to establish a related prediction model. Method A total of 120 elderly patients with liver cancer who were admitted to the hospital from May 2020 to May 2022 were selected as the research subjects all of whom underwent TACE. After operation the nutritional status of the patients was evaluated according to the overall nutritional assessment scale and the patients were divided into a malnutrition group score of 2 - 21 and a non - malnutrition group score of 0-1 . The peripheral inflammatory indexes interleukin-6 IL-6 IL-8 C-reactive protein CRP tumor necrosis factor-α TNF-α were compared between the two groups. The Spearman correlation coefficient was used to analyze the correlation between malnutrition and the above indicators in elderly TACE patients. The relevant data of the two groups of patients were collected the logistic regression model was used to screen the risk factors of postoperative malnutrition in elderly TACE patients the prediction model was established and the receiver operating characteristic ROC curve was drawn to analyze the clinical application value of the prediction model. Result 76 of the 120 patients were malnourished after TACE. The levels of serum IL-6 IL-8 CRP and TNF-α in the malnutrition group were higher than those in the non-malnutrition group P<0. 05 . Malnutrition in elderly TACE patients was positively correlated with peripheral blood inflammatory indexes IL-6 IL-8 CRP and TNF-α P<0. 05 . The BMI preoperative nutritional support ratio ALB and PAB in the malnutrition group were lower than those in the non -malnutrition group and the proportions of anemia viral hepatitis B anxiety and depression and cancer - related fatigue were higher than those in the non - malnutrition group P< 0. 05 . Elevated IL - 6 IL - 8 CRP TNF - α anemia no preoperative nutritional support anxiety and depression cancer-related fatigue and decreased ALB were independent risk factors for malnutrition in elderly TACE patients P< 0. 05 . The AUC value of the risk prediction model for predicting malnutrition in elderly TACE patients was 0. 899 and the sensitivity and specificity were 88. 4% and 87. 1% respectively. Conclusion Malnutrition is positively correlated with peripheral blood inflammatory indexes in elderly patients with liver cancer TACE. The established risk prediction model can be used to predict the risk of malnutrition in elderly patients with liver cancer after TACE.