目的 研究消化系统肿瘤患者各种血清维生素水平,分析不同类别肿瘤患者维生素缺乏的差异特点,并进一步探讨 血清维生素水平与蛋白指标和炎症指标的相关性,为临床消化系统肿瘤患者维生素补充提供科学依据。 方法 收集 2018 年 1 月至 2023 年 6 月期间海军军医大学第一附属医院 13 463 例住院消化系统肿瘤患者 9 种血清维生素的检测结果。 比较消化系 统肿瘤患者血清维生素水平,卡方检验分析各类维生素在消化系统肿瘤缺乏率的差异。 并进一步采用 Spearman 相关性分 析,探讨血清维生素与蛋白和炎症指标的相关性。 结果 消化系统肿瘤患者显著缺乏的水溶性维生素是维生素 B1 、维生素 C 和维生素 B6 ,总体缺乏率分别为 67. 75%、61. 51%、32. 17%;缺乏率最高的脂溶性维生素是维生素 D,总体缺乏率为 63. 60%。 食管癌、胃癌、肠癌、胰腺癌的维生素 B1 缺乏率明显高于肝癌患者(分别为 69. 11%、69. 03%、72. 62%、74. 14% 比 18. 41%,P < 0. 001)。 肝癌患者血清叶酸缺乏率远高于以上四种消化系统肿瘤患者( 46. 44% 比 9. 02%、13. 13%、12. 82%、 5. 70%,P < 0. 001)。 Spearman 相关性分析显示,消化系统肿瘤患者血清维生素 C、维生素 B6 的水平与血清白蛋白呈正相关(维生素 C r = 0. 207,P < 0. 001;维生素 B6 r = 0. 255,P < 0. 001),维生素 A 与 IL-1β 呈负相关( r = -0. 306, P <0. 01),维生素 B6 和 IL-6 呈负相关(r = -0. 265,P < 0. 01),维生素 C 和 TNF-α 呈负相关(r = -0. 203,P < 0. 05)。 结论 不同类型的消化系统肿瘤呈 现不同的维生素缺乏特点,临床应结合其代谢特点制定相应的营养补充方案,并关注炎症对维生素消耗的影响。

Objective This study aims to investigate the levels of various serum vitamins in patients with digestive system tumors analyze the differences in vitamin deficiencies among different categories of tumor patients and further explore the correlation between serum vitamin levels protein indicators and inflammation indicators. This research aims to provide a scientific basis for vitamin supplementation in clinical patients with digestive system tumors. Methods We collected the results of serum vitamin tests for 13 463 in-patients with digestive system tumors in Changhai Hospital from January 2018 to June 2023. Statistical software SPSS 21. 0 was used for variance analysis to compare serum vitamin levels and chi-square tests were conducted to analyze the differences in deficiency rates of various vitamins in different types of digestive system tumors. Additionally Spearman correlation analysis was employed to investigate the correlation between serum vitamins and protein and inflammation indicators Results Digestive system tumor patients significantly lack water-soluble vitamins vitamin B1 vitamin C and vitamin B6 with an overall deficiency rate of 67. 75% 61. 51% and 32. 17% respectively. The significant deficiency of fat-soluble vitamin vitamin D is observed with an overall deficiency rate of 63. 60%. The deficiency rates of vitamin B1 in esophageal cancer gastric cancer colorectal cancer and pancreatic cancer are significantly higher than those in liver cancer patients 69. 11% 69. 03% 72. 62% 74. 14% vs. 18. 41% P < 0. 001 . The serum folate deficiency rate in liver cancer patients is much higher than in the above four types of digestive system tumor patients 46. 44% vs. 9. 02% 13. 13% 12. 82% 5. 70% P < 0. 001 . Spearman correlation analysis demonstrates that the levels of serum vitamin C and vitamin B6 in digestive system tumor patients are positively correlated with serum albumin vitamin C r = 0. 207 P < 0. 001 vitamin B6 r = 0. 255 P < 0. 001 . vitamin A is negatively correlated with IL-1β r = -0. 306 P < 0. 01 vitamin B6 is negatively correlated with IL-6 r = -0. 265 P < 0. 01 and vitamin C is negatively correlated with TNF-α r = - 0. 203 P < 0. 05 . Conclusion Different types of digestive system tumors exhibit distinct patterns of vitamin deficiencies. Clinically it is essential to develop corresponding nutritional supplementation plans based on their metabolic characteristics and to pay attention to the impact of inflammation on vitamin consumption.