The Present Status Of 934 Malignant Tumor Patients Nutrition Status Survey

The mortality of patients with malignant tumor has been rising in recent years, and has constituted a serious threat to the health of our country residents. Tumor tissue will continue to proliferate, causing the body’s nutrition continues to be consumed, and abnormal metabolic state, eventually leading to the continuous deterioration of human nutrition. At present, the research on Orexin Aand the related data of the malignant tumor is seldom reported in China. The appetite of patients with malignant tumor can be greatly decreased, and then lead to the sharp drop in eating volume, weight decreased significantly,but Orexin A has the function of adjusting the feeding and energy balance, and can increase the feeding quantity and weight of tumor patients. In addition, the malignant tumor patients often appear in the malignant fluid, but Orexin A can increase the appetite of malignant tumor patients. Therefore, Orexin A is likely to improve the nutritional status of patients with malignant tumor, and then shorten the hospitalization time and reduce the cost of treatment for patients with tumor. 934 cases with malignant tumor patients were evaluated by using Patient-Generated Subjective Global Assessment method,and the correlation between serum A Orexin level and exploring 93 cases of malignant tumor of patients with orexin A levels and common nutrition index correlation. Part 1 The present status of 934 malignant tumor patients nutrition status surveyObjective:The nutritional status, the condition of nutritional support and the relationship between giving nutrition support and clinical outcome of 934 cases with malignant tumor patients were evaluated by using PG-SGA method.Methods:1 In this study, we selected subjects from the first hospital of Hebei Medical University, the second Hospital of Hebei Medical University(East court), Hengshui Halison International Peace Hospital, Xingtai People’s Hospital and Affiliated Hospital of Chengde Medical College in a total of 934 patients with malignant tumor, useing PG-SGA method to assess the nutritional status of eligible patients. Determine height, body weight, TSF, MAMC, the non-profit grip strength, leg circumference, Alb, Hb and blood glucose of patients. Calculate body mass index(BMI = height/weight 2). According PG-SGA quantitative evaluation scores or PG-SGA qualitative evaluation grades to evaluate the nutritional status of patients and grouping: good nutrition group(PG-SGA score less than 1 points or PG-SGA qualitative evaluation of Grade A), mild or moderate malnutrition group(PG-SGA quantitative score between 2~8 or PG-SGA qualitative assessment level B),severe malnutrition group(PG-SGA score greater than 9 points or PG-SGA qualitative assessment level C).2 In this study, the statistical analysis was performed using SPSS 13 statistical software for analysis. Measurement data(such as age, PG-SGA score, symptom score and nutritional evaluation index and so on) of the statistical description of the results in(x—±s),by t test,count data using frequency, constituent ratio or percentage, compared with three or more than three independent samples of fully independent multi sample single factor analysis of variance comparison. If the data did not satisfy the normality and homogeneity of variance, adoptting a plurality of independent samples to compare Kruskal-Wallis H nonparametric test, a further two two were compared using analysis of variance of rank transformation. If the data met the correlation bivariate normality, using Pearson linear correlation analysis, if not met the application conditions, using Spearman rank correlation correlation analysis. The nutritional status of patients with malignant tumor related factors using the Forward:Wald forward stepwise regression analysis was carried out by logistic.The level of test set for alpha = 0.05, with P<0.05 considered to have significant difference.Results:There were 130 cases with good nutrition(13.9%), 541 cases with mild or moderate malnutrition(57.9%), and 263 cases of severe malnutrition(28.2%);There were 59 cases of good nutrition(11.5%), 318 cases with mild or moderate malnutrition(62.1%), 135 cases of severe malnutrition(26.4%) in male patients; There were 71 cases of good nutrition(16.8%), 223 cases with mild or moderate malnutrition(52.9%), 128 cases of severe malnutrition(30.3%) in female patients. The TSF, MAMC, the non-profit grip strength, leg circumference and BMI index of good nutrition group,mild or moderate malnutrition group and severe malnutrition group were compared, and the difference had statistically significant(P=0.001<0.05);Total protein, albumin, hemoglobin and red blood cell count of good nutrition group,mild or moderate malnutrition group and severe malnutrition group were compared, the difference had statistically significant(P 均=0.001<0.05);The PG-SGA quantitative evaluation scores of good nutrition group,mild or moderate malnutrition group and severe malnutrition group were compared, the difference was statistically significant(P<0.001).Conclusions:1 The results indicate that PG-SGA is an ideal, wide application range and high specificity nutritional status evaluation tool of patients with malignant tumor evaluation tool which has good correlation with the most classical nutritional markers.We propose to assess the nutritional status of patients with malignant tumor by using PG-SGA method.2 Malignant tumor patients had a higher incidence of malnutrition and a relatively low rate of nutritional support. They should be given a reasonable nutritional support during the-peri-operation and chemotherapy. Part 2 Malignant tumor patients nutrition status and orexin A level correlation studiesObjective:To explore the lung cancer, colorectal cancer and gastric cancer of patients with orexin A levels and common nutrition index correlation and its significance.Methods:1 The serum level of orexin A, total protein, albumin, hemoglobin, blood glucose and some body measurements related to nutritional status which including TSF and BMI in patients with malignant tumor patients(including 39 cases of lung cancer, 25 cases of colorectal cancer, 29 cases of gastric cancer) were measured. Serum Orexin A levels was measured by double antibody sandwich method, and the correlation between serum Orexin A levels and each indexes was analyzed.2 Using SPSS 13 statistical software for statistical analysis of the data. To meet the normality and homogeneity of variance data, measurement data was said in(x—±s),Using t test or single factor variance analysis;if the data was not meet the normality and homogeneity of variance,using the Wilcoxon rank sum test. If the data met the correlation bivariate normality, using Pearson linear correlation analysis, if not met the application conditions, using Spearman rank correlation correlation analysis. The level of test set for alpha = 0.05, with P<0.05 considered to have significant difference.Results:The serum Orexin A in patients with lung cancer, colorectal cancer and gastric cancer are compared, the difference was statistically significant(χ2=8.54,P=0.014);study subjects were divided into two groups by 65 years of age at onset, elderly patients(aged over 65) and the non elderly patients(< 65 years) to compare the levels of serum Orexin A, the difference was statistically significant(Z=-5.899,P=0.000). Serum Orexin A levels in elderly patients was significantly lower than non elderly patients; according to BMI the subjects were divided into low weight group(BMI<18.5), normal weight group(18.5≤BMI≤23.9)and overweight and obesity group(BMI≥24.0),the serum Orexin A levels in three groups were compared, the difference was statistically significant(H=11.964,P=0.003);the serum Orexin A levels in women and men were compared, the difference was not statistically significant(Z=-1.364,P=0.173).Conclusions:The serum Orexin A levels in lung cancer, colorectal cancer and gastric cancer patients are negatively related to age, blood glucose.At the same time, BMI, age, blood glucose and have effect on the serum Orexin A levels; total protein, albumin and hemoglobin are not related to serum Orexin A levels, neither they have effect on serum Orexin A levels.