目的 探讨肝癌患者营养状态与肝功能、炎症因子及预后的相关性。 方法 选取 2019 年 1 月至 2020 年 12 月在巴彦 淖尔市医院行半肝切除术治疗的原发性肝癌患者 170 例临床资料进行回顾性分析。 通过患者主观整体评估(PG-SGA)结果 将患者进行分组,0~≤1 分组(13 例)、2~≤3 分组(34 例)、4~≤8 分组(58 例)、≥9 分组(65 例)。 比较各组患者肝功能指标 与炎症因子水平差异,分析 PG-SGA 评分与肝功能指标、炎症因子水平的相关性,并比较营养良好组(4 ~ ≤8 分组+≥9 分 组)、营养不良组(0~ ≤1 分组+ 2 ~ ≤3 分组) 预后生存状态。 结果 PG-SGA≥9 分组患者直接胆红素(DBIL)、总胆红素 (TBIL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α (TNF-α)、白细胞介素-1(IL-1)分 别高于 0~≤1 分组、2~≤3 分组、4 ~ ≤8 分组(F = 20. 870、18. 633、835. 004、1190. 48、26. 283、28. 242、31. 109,P<0. 05) ,白蛋 白(ALB)分别低于 0~≤1 分组、2~≤3 分组、4~≤8 分组(F = -18. 755,P<0. 05)。 Pearson 相关性分析显示:PG-SGA 评分与 ALB 呈负相关(r = -0. 403,P<0. 05),与 DBIL、TBIL、ALT、AST、TNF-α、IL-1、IL-6 呈正相关( r = 0. 412、0. 451、0. 862、0. 849、 0. 530、0. 543、0. 515,P<0. 05)。 Kaplan-Meier 生存分析显示,营养良好组总生存情况优于营养不良组( χ 2 = 6. 364,P<0. 05)。 结论 肝癌患者多存在营养不良状况,且营养状态与肝功能、炎症因子及预后相关密切,临床需注重肝癌患者营养状态监测,保 证患者术前营养状态良好。

Objective To investigate the Correlation analysis of nutritional status with liver function inflammatory factors and prognosis in patients with liver cancer. Method The clinical data of 170 patients with primary hepatocellular carcinoma admitted for hemihepatectomy treatment in Bayannur Hospital from January 2019 to December 2020 were selected for retrospective analysis. The patients were grouped by the subjective overall nutritional status assessment scale PG-SGA assessment results with 0-≤1 group 13 cases 2-≤3 group 34 cases 4-≤8 group 58 cases and ≥9 group 65 cases . We compared the differences in liver function indexes and inflammatory factor levels of patients in each group analyzed the correlation between PG-SGA scores and liver function indexes and inflammatory factor levels and compared the prognostic survival status of the well-nourished group group 4~≤ 8 + group ≥9 and the malnourished group group 0~≤1 + group 2-≤3 . Result Direct bilirubin DBIL total bilirubin TBIL aspartate aminotransferase AST alanine aminotransferase ALT interleukin-6 IL-6 tumor necrosis factor-a TNF-α and interleukin-1 IL-1 were higher than those in subgroups 0-≤1 2-≤3 and 4-≤8 respectively in patients of subgroups ≥9 of PG-SGA F = 20. 870 18. 633 835. 004 1190. 48 26. 283 28. 242 31. 109 P< 0. 05 and albumin ALB were lower than subgroups 0-≤1 2-≤3 and 4-≤8 respectively F = -18. 755 P<0. 05 . Person correlation analysis showed that PG-SGA score had a negative correlation with ALB r = -0. 403 P<0. 05 and a positive correlation with DBIL TBIL ALT AST TNF-α IL-1 IL-6 r = 0. 412、0. 451、0. 862、0. 849、0. 530、0. 543、0. 515 P<0. 05 . Kaplan-Meier survival Analysis showed that overall survival was better in the well-nourished group than in the malnourished group χ 2 = 6. 364 P<0. 05 . Conclusion Most liver cancer patients have malnutrition and the nutritional status is closely related to liver function inflammation factor and prognosis. The more severe the malnutrition is the worse the liver function is the more severe the inflammation level is and the worse the prognosis is clinics need to focus on monitoring the nutritional status of liver cancer patients to ensure that patients have good nutritional status before surgery.