局部晚期鼻咽癌同期放化疗患者营养状况与生活质量、免疫功能的相关分析

发布时间：2018-05-01 09:37

本文选题：鼻咽癌 + 局部晚期　；参考：《广西医科大学》2012年硕士论文

【摘要】：目的描述局部晚期鼻咽癌同期放化疗患者不同时间段的营养状况、生活质量及免疫功能并进行比较分析，探讨三者间的相关性。方法2010年10月至2011年3月，对136例局部晚期鼻咽癌同期放化疗患者采用问卷调gＨ炕颊咴谌朐菏蓖瓿梢话阕柿鲜占⒓蛞子兰畚示恚∕NA)、生活质量核心问卷(QLQ-C3())、头颈部癌症生活质量量表(QLQ-HN35)以及生化和免疫指标测定；并分别对全部患者于同期放化疗第1天，第7天，第14天，第21天，第28天，第35天，第42天，第49天，第56天，治疗后3个月和6个月，进行生活质量测评、症状记录和体重测量；于第14天，第28天，第42天，，第56天，治疗后3个月和6个月，分别对患者进行营养状况和生化、免疫指标测评。所有资料应用SSPS13.0软件进行描述性和相关性统计分析。结果 1. 局部晚期鼻咽癌同期放化疗患者不同时间段营养状况的差异有统计学意义（P〈0.05)。 2. 局部晚期鼻咽癌同期放化疗患者不同时间段生活质量的差异有统计学意义（P0.05)。 3. 局部晚期鼻咽癌同期放化疗患者不同时间段的免疫功能的差异有统计学意义（P0.05),治疗结束后3个月患者细胞免疫中CM/CD8比值和体液免疫中IgM与治疗期间差异有统计学意义外（P0.05)，细胞免疫中CD3、 CD4、CD8和体液免疫中IgA、IgG五项均与治疗期间差异无统计学意义（P0.05);治疗结束后6个月患者的免疫功能与治疗期间的差异有统计学意义(P0.05)。 4. 单因素分析：局部晚期鼻咽癌同期放化疗患者不同时间段生活质量中疲劳（r=-0.672)、恶心呕吐（r=-0.388).疼痛（r=-0.454)、失眠（r=-0.386)、食欲丧失（r=-0.596)、便秘（r=-0.286)、腹泻（r=-0.218)、经济困难（r=-0.555)、口干（r=-0.430)、唾液粘稠（r=-0.177)、止痛药物(r=-0.166)、营养支持（r=-0.213)、与营养状况负相关；躯体功能(r=0.619)、角色功能（r=0.710)、情绪功能（r=0.541)、认知功能(r=0.701)、总体健康状况（r=0.727)、吞咽（r=0.383)、感觉（r=0.375)、社交进食（r=0.310)、社交接触（r=0.372)、体重变化（r=0.107)与营养状况正相关；张口困难（r=0.030)、咳嗽（r=-0.061)、感觉生病（r二-0.045)与营养状况无相关；局部晚期鼻咽癌同期放化疗患者不同时间段免疫功能中IgA (r=0.354)、 IgG (r:(0.599)、 IgM (r=0.341)、 CDS (r=0.377)、CD4(r=0.240)、 CDS (r=0.367)与营养状况正相关；CM/CD8(r=-0.159)与营养状况负相关。 5. 多因素分析：由总体健康状况、认知功能、止痛药物、情绪功能、IgG、疲劳、腹泻、IgA、口干、唾液粘稠、食欲丧失、失眠参与构建了多重回归模型，与营养状况有线性关系(P0.05)，是影响营养状况有统计学意义的因素。结论 1. 局部晚期鼻咽癌患者在整个治疗期间患者营养状况呈逐步下降趋势，持续时间长。 2. 局部晚期鼻咽癌患者同期放化疗过程中整体生活质量和免疫功能持续下降；治疗结束后6个月，患者生活质量有改善的趋势，但未能恢复到治疗前；免疫功能改善不明显。 3. 局部晚期鼻咽癌同期放化疗患者的营养状况与总体健康状况、认知功能、止痛药物、情绪功能、IgG、疲劳、腹泻、IgA、口干、唾液粘稠、食欲丧失、失眠等多个因素相关。
[Abstract]:Objective to describe the nutritional status, quality of life and immune function of patients with locally advanced nasopharyngeal carcinoma during the period of concurrent chemoradiotherapy, and to compare and analyze the correlation between the three.
Methods from October 2010 to March 2011, 136 patients with locally advanced nasopharyngeal carcinoma were treated with G? H? Do not treat all patients with first days, seventh days, fourteenth days, twenty-first days, twenty-eighth days, thirty-fifth days, forty-second days, forty-ninth days, fifty-sixth days, 3 months and 6 months after treatment. The quality of life, symptom records and weight measurements are carried out on the day of fourteenth, twenty-eighth days, forty-second days, postoperative months and months. Biochemical and immune indicators were evaluated. All data were analyzed by descriptive statistics and correlation analysis using SSPS13.0 software.
Result
1. the nutritional status of patients with locally advanced nasopharyngeal carcinoma who had concurrent chemoradiotherapy at different time periods was statistically significant (P < 0.05).
2. the quality of life of patients with locally advanced nasopharyngeal carcinoma who had concurrent chemoradiotherapy at different times was statistically significant (P0.05).
3. the difference of immune function of patients with local advanced nasopharyngeal carcinoma during the same period of radiotherapy and chemotherapy was statistically significant (P0.05). The difference of CM/CD8 ratio and IgM in humoral immunity in the 3 months after the treatment was statistically significant (P0.05). CD3, CD4, CD8, and humoral immunity were IgA and IgG five items in cellular immunity There was no significant difference between the two groups (P0.05), and there was a significant difference in the immune function between the 6 months after treatment and the treatment period (P0.05).
4. single factor analysis: fatigue (r=-0.672), nausea and vomiting (r=-0.388), pain (r=-0.454), insomnia (r=-0.386), loss of appetite (r=-0.596), constipation (r=-0.286), r= -0.218 (r= -0.218), r=-0.555 (r=-0.555), dry mouth (r=-0.430), saliva sticky (r=-0.177), analgesic drugs (r=-0.166), nutritional support (r=-0.213), negative correlation with nutritional status; body function (r=0.619), role function (r=0.710), emotional function (r=0.541), cognitive function (r=0.701), overall health status (r=0.727), swallowing (r=0.383), sense (r= 0.375), social eating (r=0.310), social contact (r=0.372), body weight change (r=0.107) and nutrition status is positively related. R=0.030, r=-0.061, and feeling ill (r two -0.045) are not related to nutritional status; IgA (r=0.354), IgG (r: (0.599), IgM (r=0.341), CDS (R)) in patients with locally advanced nasopharyngeal carcinoma during the same period of radiotherapy and chemotherapy are positively related to nutritional status; The nutritional status was negatively correlated.
5. multi factor analysis: the multiple regression model was constructed from the overall health status, cognitive function, analgesic drugs, emotional function, IgG, fatigue, diarrhea, IgA, dry mouth, saliva stickily, loss of appetite, and insomnia, and had a linear relationship with nutritional status (P0.05), which was a significant factor affecting the nutritional status.
conclusion
1. the nutritional status of patients with locally advanced nasopharyngeal carcinoma decreased gradually during the whole treatment period and lasted for a long time.
2. in patients with locally advanced nasopharyngeal carcinoma, the overall quality of life and immune function continued to decrease during the concurrent chemoradiotherapy, and the quality of life improved in the 6 months after the end of the treatment, but the immune function was not improved obviously before the treatment was restored to the treatment.
3. the nutritional status of patients with locally advanced nasopharyngeal carcinoma during concurrent chemoradiotherapy is related to the overall health status, cognitive function, analgesic drugs, emotional function, IgG, fatigue, diarrhea, IgA, dry mouth, saliva sticky, loss of appetite, insomnia and so on.

【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R739.63

【参考文献】