Rzepecki P, Barzal J, Sarosiek T, Oborska S, Szczylik C
Bone Marrow Transplantation Unit, Military Institute of Health Services, Warsaw, Poland.
Transplant Proc. 2007 Nov;39(9):2902-4. doi: 10.1016/j.transproceed.2007.08.067.
Since changes in nutritional indices after hematopoietic stem cell transplantation (HSCT) have not been well studied, there is no definition of risk factors for the development of malnutrition, and the inception of total parenteral nutrition (TPN). We sought to analyze changes in nutritional status parameters and acute phase protein levels as qualifications for TPN. Nutritional status was assessed in 54 patients during autologous (n = 30) on allogeneic (n = 24) transplantations. Eight of 15 patients who had to be treated with TPN, needed prolonged hospitalization (>5 weeks). We assessed biochemical and anthropometric indices of nutritional status, body fat and resting energy expenditure, and acute phase protein levels on the day before starting a conditioning regimen, after chemotherapy completion, and every 7 days until engraftment, which was at least three times after stem cell infusion. Wilcoxon test and canonical analysis were used for statistical analyses. The measurement of body weight and retinol binding protein or transferrin may be useful for nutritional assessment during autologous or allogeneic HSCT, respectively. Prealbumin level, measured 8 days after the end of the conditioning regimen was helpful to make a decision about starting TPN.
由于造血干细胞移植（HSCT）后营养指标的变化尚未得到充分研究，因此对于营养不良发生的危险因素以及全胃肠外营养（TPN）的起始尚无明确界定。我们试图分析营养状况参数和急性期蛋白水平的变化，以此作为TPN使用的依据。在54例进行自体移植（n = 30）和异体移植（n = 24）的患者中评估了营养状况。15例必须接受TPN治疗的患者中有8例需要延长住院时间（>5周）。我们在开始预处理方案前一天、化疗结束后以及直至植入（干细胞输注后至少三次）前每7天评估营养状况、体脂和静息能量消耗的生化及人体测量指标，以及急性期蛋白水平。采用Wilcoxon检验和典型分析进行统计分析。体重测量以及视黄醇结合蛋白或转铁蛋白的检测可能分别有助于自体或异体HSCT期间的营养评估。预处理方案结束8天后测得的前白蛋白水平有助于决定是否开始TPN治疗。
