【摘要】 恶性肿瘤与良性疾病导致的营养不良有显著差别,突出表现在如下7个方面。①营养不良发生率更高,79.4%的住院肿瘤患者存在不同程度的营养不良;②静息能量消耗升高:尽管不同肿瘤、同一肿瘤不同阶段的能量消耗不尽相同,但在整体上,恶性肿瘤患者的静息能量消耗平均升高10%,特殊的糖代谢使患者每天额外消耗大约300kcal能量;③持续的生理、心理应激静息能量消耗升高:恶性肿瘤诊断本身、伴随症状及其治疗都给患者的身体、心理都带来巨大的创伤和应激;④慢性低度不可逆炎症:恶性肿瘤本质上是一种慢性低度不可逆炎症,其营养不良是一种伴随慢性炎性反应的营养不良,即恶液质;⑤消耗性代谢紊乱或重编程:恶性肿瘤作为一种代谢病,肿瘤细胞经过代谢重编程,表现出有别于正常细胞的物质代谢,在炎症介质、代谢因子的作用下,发生显著的消耗性代谢紊乱;⑥显著肌肉减少:由于炎性反应及分解代谢,恶性肿瘤患者的全身肌肉减少,是体重下降的重要原因;⑦治疗更加困难,需要综合治疗,尤其是代谢调节治疗。肿瘤恶性程度越高,上述特征越明显。恶性肿瘤营养不良具有显著的特征,因此,其治疗也显著有别于良性疾病营养不良。更多还原

【Abstract】 There are significant differences between malnutrition caused by malignant tumors and benign diseases,which are manifested in the following seven aspects.① the incidence of malnutrition is higher,79.4% of inpatients with tumor have different degrees of malnutrition;②resting energy expenditure is increased:the energy expenditure of different tumors and different stages of the same tumor is different,but on the whole,the resting energy expenditure of patients with tumor increased by 10% on average,and the special glucose metabolism made the patients consume additionally about 300 kcal energy every day;③sustained physiological and psychological stress:the diagnosis of cancer itself,accompanying symptoms and treatment all brought huge trauma and stress to the patients’ body and mind;④chronic low-grade irreversible inflammation:the nature of cancer is chronic low degree irreversible inflammation;its malnutrition is a kind of disorder accompanied by inflammatory reaction,that is,cachexia;⑤ wasting metabolic disorder:as a metabolic disease,malignant tumor is different from that of normal cells in the metabolism and metabolic reprogramming.Under the effect of inflammatory mediators and metabolic factors,there is significant wasting metabolic disorder;⑥significant muscle loss:due to inflammatory reaction and catabolism,the whole body muscle loss of patients with malignant tumors are important reasons for weight loss;⑦treatment is more difficult:it often requires more comprehensive treatment,especially metabolic modulation treatment.The more malignant the tumor is,the more obvious the above characteristics are.Malnutrition of malignant tumor has significant characteristics,so its treatment is also significantly different from that of benign diseases.更多还原