Oğuz A, Karadeniz C, Pelit M, Hasanoğlu A
Department of Pediatric Oncology, Gazi University, Faculty of Medicine, Beşevler, Ankara, Turkey.
Pediatr Hematol Oncol. 1999 Jan-Feb;16(1):35-41. doi: 10.1080/088800199277579.
Malnutrition in children with cancer is reported to be relatively uncommon at the time of diagnosis. However, in most studies nutritional status measurement has relied almost exclusively on weight-related indices. This can be misleading, because in children with malignancy, tumor masses can reach more than 10% of total body weight. A controlled study was performed in 62 patients using arm anthropometry to provide a more accurate evaluation of the nutritional status of children with cancer at presentation. Height, weight, midupper arm circumference (MUAC), and triceps skinfold thickness (TSFT) were measured in all patients (40 boys, 22 girls) and controls (18 boys, 13 girls). Weight for height (WFH) of each patient was compared with the national standards. MUAC and TSFT were also interpreted according to the standards developed by A. Roberto Frisancho. The mean ages were 6.5 +/- 3.7 years (range 0.08-13) and 5.7 +/- 4.7 years (range 0.25-15) in patients and control group, respectively. Results showed that although the WFH values for patients were normal, MUAC and TSFT values were significantly less than control values (P < 0.001). Moreover, 27% of patients showed malnutrition (they had MUAC and TSFT below 5th percentile). Patients with intraabdominal solid tumors had significantly lower MUAC and TSFT values than those with extraabdominal solid tumors (P < 0.05). The data strongly indicate that malnutrition is common at the time of diagnosis in children with cancer, and arm anthropometry should replace the use of weight-related indices to identify malnutrition in children.
据报道，癌症患儿在确诊时营养不良相对不常见。然而，在大多数研究中，营养状况测量几乎完全依赖于与体重相关的指标。这可能会产生误导，因为在恶性肿瘤患儿中，肿瘤肿块可达到总体重的10%以上。对62例患者进行了一项对照研究，采用手臂人体测量法，以便在就诊时更准确地评估癌症患儿的营养状况。对所有患者（40名男孩，22名女孩）和对照组（18名男孩，13名女孩）测量了身高、体重、上臂中部周长（MUAC）和三头肌皮褶厚度（TSFT）。将每位患者的身高体重比（WFH）与国家标准进行比较。MUAC和TSFT也根据A.罗伯托·弗里桑乔制定的标准进行解读。患者组和对照组的平均年龄分别为6.5±3.7岁（范围0.08 - 13岁）和5.7±4.7岁（范围0.25 - 15岁）。结果显示，虽然患者的WFH值正常，但MUAC和TSFT值显著低于对照组（P < 0.001）。此外，27%的患者表现出营养不良（他们的MUAC和TSFT低于第5百分位数）。腹腔内实体瘤患者的MUAC和TSFT值明显低于腹腔外实体瘤患者（P < 0.05）。数据有力地表明，癌症患儿在确诊时营养不良很常见，手臂人体测量法应取代使用与体重相关的指标来识别儿童营养不良。
