目的 探讨胃癌患者与肿瘤临床分期、特征因素、化疗后消化道不良反应及外周血炎症指标的相关性,并评价四肢 骨骼肌指数(ASMI)与患者主观整体评估量表(PG-SGA)两种评估方式对患者营养状况评定的相关性。 方法 收集中国科学 技术大学附属第一医院(西区)2019 年 1 月至 2022 年 2 月共 125 例晚期胃癌患者的临床资料,运用 Pearson 相关分析法分析 ASMI 与 PG-SGA 评分的相关性。 结果 125 例患者中发生肌肉减少症者占 54 例(43. 2%),且肌肉减少症患者年龄较非肌肉 减少症者更大,化疗后Ⅲ/ Ⅳ级不良反应发生率更高(P<0. 001)。 此外,肌肉减少症组患者的体质指数更低,而 PG-SGA 评分、 中性粒细胞与淋巴细胞比值(NLR)更高(P<0. 05)。 多因素分析显示,年龄、PG-SGA 评分、化疗后Ⅲ/ Ⅳ级不良反应、NLR 为 肌肉减少症发生的独立危险因素(P<0. 05)。 ASMI 与 PG-SGA 评分具有显著负相关性(r = -0. 38,P <0. 001)。 结论 高龄、化疗后不良反应发生严重情况及患者全身炎症状态与晚期胃癌肌肉减少症发生密切相关,且 ASMI 与 PG-SGA 这两种评估方式 对患者营养状况的评定具有较好相关性。

Objective To explore the correlation between sarcopenia and tumor clinical stage characteristics adverse reactions after chemotherapy and peripheral blood inflammatory indexes. Moreover the correlation between appendicular skeletal mass index ASMI and the patient-generated subjective global assessment PG-SGA for the assessment of patient nutritional status were also be analyzed. Method The clinical data of 125 patients with advanced gastric cancer in the First Affiliated Hospital of University of Science and Technology of China Western District from January 2019 to February 2022 were collected. Pearson analysis was carried out to analyze the correlation between ASMI and PG-SGA score. Result Among the 125 patients the incidence of sarcopenia was 43. 2% 54 of 123 patients . The sarcopenia group was significantly older and the incidence of grade Ⅲ/ Ⅳ adverse reactions after chemotherapy was higher In addition the sarcopenia group showed lower BMI but higher PG-SGA score and NLR neutrophil-to-lymphocyte ratio NLR P <0. 05 . Univariate analysis and multivariate analysis showed that age PG-SGA score grade Ⅲ/ Ⅳ adverse reaction after chemotherapy and NLR were independent risk factors for sarcopenia P < 0. 05 . There was a significant negative correlation between ASMI and PG-SGA score r = - 0. 38 P < 0. 001 . Conclusion Advanced age the occurrence of adverse reactions after chemotherapy and the systemic inflammatory state of patients are closely related to the occurrence of sarcopenia in advanced gastric cancer. ASMI and PG-SGA have a good correlation in the evaluation of nutritional status of patients.