O'Gorman P, McMillan D C, McArdle C S
Royal Infirmary, Glasgow, UK.
Nutr Cancer. 1999;35(2):127-9. doi: 10.1207/S15327914NC352_5.
There is increasing evidence that, in most patients with advanced cancer, weight loss is associated with an inflammatory response. To examine the temporal relationship between weight loss, appetite, performance status, and the inflammatory response, 50 patients with advanced gastrointestinal cancer with weight loss were observed for six weeks. Patients were grouped according to whether they had lost weight (> 3%, n = 16), were weight stable (< 3% change, n = 25), or gained weight (> 3%, n = 9). At baseline, the group that subsequently lost weight had lower albumin and higher C-reactive protein concentrations (p < 0.05). On follow-up, there was an increase in C-reactive protein concentration and reductions in triceps skinfold thickness and Karnofsky performance status in the weight-losing group (p < 0.05). In contrast, Karnofsky performance status was improved in the group that gained weight (p < 0.05). Over the six to eight weeks, there was a difference in the changes of triceps skinfold thickness (p < 0.05) and Karnofsky performance status (p < 0.01) between the two groups. These results suggest that loss or gain of > 2.5 kg over a six- to eight-week period is required to produce a significant alteration in performance status in weight-losing patients with gastrointestinal cancer. Moreover, the results suggest that the presence of an inflammatory response is associated with further weight loss and the deterioration of performance status.
越来越多的证据表明，在大多数晚期癌症患者中，体重减轻与炎症反应有关。为了研究体重减轻、食欲、体能状态和炎症反应之间的时间关系，对50例体重减轻的晚期胃肠道癌患者进行了为期六周的观察。患者根据体重是否下降（>3%，n = 16）、体重稳定（变化<3%，n = 25）或体重增加（>3%，n = 9）进行分组。在基线时，随后体重下降的组白蛋白水平较低，C反应蛋白浓度较高（p<0.05）。在随访中，体重减轻组的C反应蛋白浓度升高，肱三头肌皮褶厚度和卡氏功能状态降低（p<0.05）。相比之下，体重增加组的卡氏功能状态有所改善（p<0.05）。在六至八周内，两组之间肱三头肌皮褶厚度的变化（p<0.05）和卡氏功能状态的变化（p<0.01）存在差异。这些结果表明，在体重减轻的胃肠道癌患者中，在六至八周内体重增减>2.5 kg才会使体能状态产生显著改变。此外，结果表明炎症反应的存在与体重进一步减轻和体能状态恶化有关。
