Eriksson K M, Cederholm T, Palmblad J E
Department of Medicine, Stockholm Söder Hospital, Sweden.
Cancer. 1998 Mar 15;82(6):1071-7.
The purpose of this study was to determine whether nutritional state was related to infectious complications in adult patients with acute leukemia.
During first-remission induction therapy (mean, 71 days), the duration of neutropenia, various infections, and fevers were related to changes in body weight and serum albumin concentrations as well as total parenteral nutrition (TPN) in 52 patients receiving standardized anti-infectious treatment.
Severe neutropenia prevailed for 27% and fever for 28% of the induction period. A mean weight loss of 5.1 kg, corresponding to a reduction of body mass index from 23.5 to 21.7, was correlated with the number of days that patients had fever (P = 0.026). Despite a normal serum albumin value at the time of admission, patients had severe hypoalbuminemia (<25 g/L) during 16% of the induction period. The drop in serum albumin was independently related to the weight loss (r = 0.37, P = 0.03). Moreover, the incidence and duration of hypoalbuminemia were significantly correlated with duration of fever (P < 0.0001), diarrhea (P = 0.03), and TPN administration (P = 0.00002).
Weight loss and severe hypoalbuminemia were common during remission induction for these adult patients with acute leukemia and were closely related to the patients' infections.
本研究旨在确定营养状况是否与成年急性白血病患者的感染并发症相关。
在52例接受标准化抗感染治疗的患者中，于首次缓解诱导治疗期间（平均71天），将中性粒细胞减少症的持续时间、各种感染及发热情况与体重变化、血清白蛋白浓度以及全胃肠外营养（TPN）进行关联分析。
诱导期27%的时间出现严重中性粒细胞减少，28%的时间出现发热。平均体重减轻5.1 kg，体重指数从23.5降至21.7，这与患者发热天数相关（P = 0.026）。尽管入院时血清白蛋白值正常，但患者在诱导期16%的时间内出现严重低白蛋白血症（<25 g/L）。血清白蛋白下降与体重减轻独立相关（r = 0.37，P = 0.03）。此外，低白蛋白血症的发生率和持续时间与发热持续时间（P < 0.0001）、腹泻（P = 0.03）及TPN使用情况（P = 0.00002）显著相关。
对于这些成年急性白血病患者，在缓解诱导期间体重减轻和严重低白蛋白血症较为常见，且与患者感染密切相关。
