目的 探讨中上臂围(MUAC)和三头肌皮褶厚度(TSFT)在肿瘤患儿营养评估中的应用价值。 方法 纳入 2020 年 1 月至 2021 年 12 月华中科技大学协和东西湖医院/ 武汉市东西湖区人民医院 162 例肿瘤患儿为研究对象,根据双能 X 射线吸 收法评估患儿营养状态,并根据患儿营养状态分为营养不良组(68 例)和正常组(94 例),营养不良组男 35 例,女 33 例;年龄 (8. 12±2. 01)岁;正常组男 58 例,女 36 例;年龄(7. 89±1. 59)岁。 测量所有患儿 MUAC、TSFT 水平及体质指数、白蛋白水平、前 白蛋白水平;采用 Spearman 相关系数分析 MUAC、TSFT 水平与体质指数、白蛋白水平、前白蛋白水平的相关性;并分析比较 MUAC、TSFT 水平单独诊断及联合诊断肿瘤患儿营养不良的价值,诊断价值使用 Kappa 值表示。 结果 肿瘤患儿 MUAC、TSFT、 体质指数、白蛋白、前白蛋白水平略低;Spearman 分析显示,MUAC、TSFT 与体质量指数、白蛋白、前白蛋白均具相关性(P< 0. 05),且 MUAC 在正常组与营养不良组中与白蛋白的相关性更强,TSFT 在营养不良组不良组与白蛋白相关性更强,在正常 组与前白蛋白相关性更强;MUAC、TSFT 诊断肿瘤患儿营养不良的 Kappa 值分别 0. 886 和 0. 897,均高于体质指数的 0. 860 及 白蛋白联合前白蛋白的 0. 885,但低于 MUAC 联合 TSFT 诊断的 0. 949(P<0. 05)。 结论 MUAC、TSFT 均可用于临床肿瘤患儿 营养不良的诊断,但两者联合诊断临床价值更高。

Objective To explore the application value of mid-upper arm circumference MUAC and triceps skinfold thickness TSFT in nutritional evaluation of children with tumor. Method From January 2020 to December 2021 162 children with tumor in Department of Pediatrics Union East West Lake Hospital and The Second Department of Pediatrics Huangpi District People's Hospital were selected as the research objects. According to the dual-energy X-ray absorption method the nutritional status of children was evaluated and they were divided into malnutrition group and normal group according to their nutritional status. The levels of MUAC TSFT body mass index albumin and prealbumin in all children were measured. Spearman correlation coefficient was used to analyze the correlation between MUAC and TSFT levels and body mass index albumin level and prealbumin level. The value of MUAC and TSFT levels in diagnosis of malnutrition in children with tumor alone and jointly was analyzed and compared and the diagnostic value was expressed by Kappa value. Result The levels of MUAC TSFT BMI albumin and prealbumin in children with tumor were lower than the reference values. Spearman analysis showed that MUAC and TSFT had correlation with body mass index albumin and prealbumin P< 0. 05 . moreover MUAC had a stronger correlation with albumin in the normal group and the malnutrition group. TSFT had a stronger correlation with albumin in the malnutrition group and with prealbumin in the normal group. Kappa values of MUAC and TSFT were 0. 886 and 0. 897 respectively which were higher than 0. 860 of BMI and 0. 885 of albumin combined with prealbumin but lower than 0. 949 of MUAC combined with TSFT P < 0. 05 . Conclusion Both MUAC and TSFT can be used in the diagnosis of malnutrition in children with clinical tumors but their combined diagnosis has higher clinical value.