目的 评估造血干细胞移植患者营养相关指标的变化,探讨其与患者预后的关系,为临床实施营养干预提供依据。 方法 收集 2016 年 10 月至 2020 年 10 月徐州医科大学附属淮安医院 68 例造血干细胞移植患者的临床资料,监测患者移植前 及移植后 14 d、30 d、60 d、90 d 的体重、体质指数(BMI)、生化等营养相关指标,分析其与急性移植物抗宿主病( aGVHD)的发 生及临床结局的关系。 结果 患者移植后存在着营养风险:①移植后患者 BMI 较移植前明显下降,其中移植后 90 d 下降最为 明显(P<0. 05);②移植后早期阶段患者白蛋白及前白蛋白较移植前明显下降,移植后期阶段较早期阶段有所上升(P<0. 05); ③移植后甘油三酯较移植前明显升高,高密度脂蛋白胆固醇较移植前明显下降(P<0. 05)。 移植后发生 aGVHD 组的患者血 糖、甘油三酯水平高于未发生 aGVHD 组的患者(P<0. 05);移植后发生 aGVHD 组的患者白蛋白、前白蛋白均低于未发生患者 (P<0. 05)。 存活患者的总蛋白、白蛋白水平均高于非存活患者。 结论 患者体成分及生化指标能综合评估造血干细胞移植患 者的营养状况,发生 aGVHD 组的患者营养状况较差,营养状况良好的患者预后优于营养状况差的患者。

Objective To evaluate the nutrition status in patients with hematopoietic stem cell transplantation HSCT and its influence on prognosis. Method Clinical data from 68 patients with hematopoietic stem cell transplantation was collected. The body weight body mass index BMI biochemicals and other nutrition-related indexes were monitored before transplantation and 14 days 30 days 60 days and 90 days after transplantation and their correlation with acute graft versus host disease aGVHD and clinical outcomes were analyzed. Result Patients are at risk of malnutrition after transplantation ① BMI of patients exhibited a significant decrease after transplantation compared to the pre - transplantation in particular BMI at 90 days after transplantation decreased dramatically P<0. 05 ②Albumin and prealbumin decreased significantly in the early stage after transplantation and increased in the late stage of transplantation compared with the early stage P<0. 05 ③After transplantation triglyceride was significantly higher than before transplantation and high-density lipoprotein cholesterol was significantly lower than before transplantation P<0. 05 . The blood glucose and triglycerides of patients with aGVHD after transplantation were higher than those without aGVHD P<0. 05 The albumin and prealbumin of the aGVHD group after transplantation were lower than those without aGVHD group P< 0. 05 . Patients in the survival group had higher amounts of albumin and total protein than those in the non - survival group P < 0. 05 . Conclusion The nutrition status of patients receiving hematopoietic stem cell transplantation can be assessed by using body composition and biochemical indexs. Patients with aGVHD have a worse nutritional state than patients without aGVHD while those with good nutritional status have a better prognosis than those with poor nutritional status.