目的 采用生物电阻抗法(BIA)监测头颈部肿瘤围放疗期人体成分,探索人体成分变化及其与骨髓抑制的关系。 方 法 选取 2022 年 9 月至 2023 年 3 月在四川大学华西医院放疗的头颈部肿瘤患者共 60 例,采集患者放疗前、放疗 2 周、放疗 4 周生化指标及人体成分。 按是否发生骨髓抑制分组,比较两组患者人体成分随放疗时间变化差异。 计算相位角(PA)和骨髓 抑制发生率的风险比大小。 比较低 PA 组和正常 PA 组,两组患者白细胞、中性粒细胞、血小板、血红蛋白随放疗时间变化差 异。 结果 所有患者人体成分相关指标在放疗过程中都有明显下降(P<0. 05)。 发生骨髓抑制组体脂肪、内脏脂肪面积均高于 未发生骨髓抑制组(P<0. 05),其余指标低于未发生骨髓抑制组(P<0. 05)。 低 PA 组血红蛋白、白细胞均低于正常 PA 组(P< 0. 05),且低 PA 组发生骨髓抑制的风险是正常 PA 组的 3. 75 倍(OR= 3. 75;95%CI = 1. 27~ 9. 83)。 结论 随着放疗的进展,头颈部肿瘤患者人体成分均会发生衰减,但发生骨髓抑制的患者人体成分测量数据表现更差。 PA 和骨髓抑制发生密切相关,低PA 患者更容易出现骨髓抑制。 监测 PA 更容易发现潜在的骨髓抑制风险,有助于及时进行营养干预,改善预后。

Objective Using biological impedance analysis to monitor the body composition through the peri - radiation period. Exploring the relationship between the changes in body composition and its relationship with myelosuppression. Method A total of 60 patients with head and neck tumors in our hospital were selected from September 2022 to March 2023. The patients were collected biochemical indicators and body composition before radiotherapy 2 weeks of radiotherapy 4 weeks of radiotherapy. According to myelosuppression occurs we compared the difference in body composition of the two groups with the radiotherapy time. Computing the risk ratio of PA phase angle with myelosuppression. Comparing patients' white blood cells neutral granulocytes platelets and hemoglobin changes in low PA group and normal PA group with radiotherapy time. Result All patients' body composition have significantly decreased during radiotherapy P<0. 05 . For the myelosuppression group the contents of fat mass and visceral fat area were higher than the normal group P<0. 05 and other related indicators were lower P<0. 05 . Compared with normal PA group hemoglobin and white blood cells were lower than the normal PA group P<0. 05 and the risk of myelosuppression in low PA group is higher OR= 3. 75 95%CI = 1. 27-9. 83 . Conclusion With the progress of radiotherapy the body composition of each human will be attenuated. However the body composition measurement data of patients with myelosuppression were worse. PA of patients with head and neck tumors are closely related to myelosuppression and low PA patients are more likely to cause myelosuppression. Monitoring PA can detect the potential risk of myelosuppression which helps to conduct nutritional intervention in time and improve prognosis.