目的 采用质谱技术分析住院肿瘤患者维生素缺乏情况,探索维生素缺乏与营养风险和营养不良的相关性,为肿瘤 患者营养治疗提供科学的参考依据。 方法 分析 2021 年 8 月至 2022 年 6 月在北京市朝阳区桓兴肿瘤医院住院并进行维生素 水平检测的 1257 例肿瘤患者,采用 Qlife Lab 9000plus 液相色谱-三重四极杆串联质谱仪测定维生素,分析各种维生素缺乏的 比例;采用营养风险筛查 2002(NRS 2002)进行营养风险筛查,采用全球营养不良领导倡议标准进行营养不良的诊断;分析营 养风险或营养不良与维生素缺乏的相关性。 分类变量采用卡方检验或 Fisher 确切概率法进行比较,有序变量采用 MannWhitney U 检验进行比较。 结果 本研究所纳入的 1257 例肿瘤患者,平均年龄为(59. 71± 11. 17) 岁,男性 783 例,女性 474 例,平均体质指数为(23. 35±3. 62)kg / m 2 ;营养风险发生率为 35. 88%(NRS 2002 评分≥3 分),营养不良发生率为 22. 12%。 水 溶性维生素均有不用程度的缺乏,其中维生素 B1 缺乏占比最多,为 80. 9%,维生素 B3 缺乏占比最少,仅 1. 4%;脂溶性维生素 中仅维生素 D 缺乏较多,占 89. 4%。 相比于无营养风险患者,有营养风险患者在维生素 A 和维生素 C 缺乏比例差异有统计学 意义(P<0. 05),分别为 2%比 5. 3%,39%比 45. 5%;相比于无营养不良患者,有营养不良患者在维生素 A 和叶酸缺乏比例差 异有统计学意义(P<0. 05),分别为 2. 2%比 6. 6%,55. 1%比 47. 6%。 结论 住院肿瘤患者维生素 D、维生素 B1 、叶酸和维生素 C 缺乏比例较高,肿瘤患者营养评价应考虑维生素水平的检测,指导临床合理补充维生素。

Objective To analyze the vitamin deficiency of hospitalized cancer patients explore the correlation between vitamin deficiency and nutritional risk and malnutrition and provide scientific reference basis for nutritional intervention of cancer patients. Method A total of 1257 cancer patients in our hospital from August 2021 to June 2022 were selected vitamins were determined using Qlife Lab 9000plus liquid chromatography triple quadrupole tandem mass spectrometer to analyze the proportion of various vitamin deficiencies. Nutritional risk screening 2002 was used for nutritional risk screening and the Global Leadership Initiative on Malnutrition standard was used for the diagnosis of malnutrition. Analyze the correlation between nutritional risk or malnutrition and vitamin deficiency. Result The average age of 1257 cancer patients was 59. 71 ± 11. 17 years old. There were 783 males and 474 females with an average body mass index of 23. 35 ± 3. 62 kg / m 2 . The incidence of nutritional risk was 35. 88% NRS 2002 ≥ 3 points and the incidence of malnutrition was 22. 12% . All water - soluble vitamins are deficient with varying degrees with vitamin B1 deficiency accounting for the most 80. 9% and vitamin B3 deficiency accounting for the least 1. 4% . Fat soluble vitamins were deficient in vitamin D alone accounting for 89. 4%. Compared with patients without nutritional risk there was a statistically significant difference in the proportion of vitamin A and vitamin C deficiency among patients with nutritional risk 39% vs. 45. 5% P<0. 05 . Compared with patients without malnutrition there was a statistically significant difference in the proportion of vitamin A and folic acid deficiency among patients with malnutrition 55. 1% vs. 47. 6% P<0. 05 . Conclusion The proportion of vitamin D vitamin B1 folic acid and vitamin C deficiency in hospitalized cancer patients was high. The nutritional evaluation of cancer patients should consider the vitamin levels to guide rational vitamin supplementation in clinic.