【摘要】 目的 探讨海洋生物活性肽联合常规口服营养补充(oral nutritional supplement, ONS)干预对恶性肿瘤患者营养状况的影响，评估营养支持方案。方法 采用临床随机对照试验，纳入南方医科大学深圳医院和广西医科大学第一附属医院2021年9-11月确诊消化系统肿瘤患者共108例为研究对象。采用随机数字法将患者分为对照组、ONS组、ONS+活性肽组，3组均接受营养会诊及饮食指导，建议患者均衡膳食。ONS组接受加餐常规口服营养液，ONS+活性肽组在ONS基础上联合18 g/d海洋生物活性肽，比较3组患者入院时和8周的主要观察指标变化，包括NRS2002评分、PG-SGA评分、体质量、体质指数(body mass index, BMI)、肌肉量、脂肪量、上臂肌围、小腿围、握力，次要观察指标包括腰围、臀围、血清白细胞计数、红细胞计数、血红蛋白、白蛋白、总蛋白水平。结果 对照组36例、ONS组33例和ONS+活性肽组30例最终完成临床随访。3组患者的一般临床资料具有可比性(P>0.05)。随访8周后，对照组患者NRS2002评分和PG-SGA评分明显增高，体质量、BMI、体脂肪量、上臂肌围、小腿围、腰围、臀围、握力水平、白蛋白水平显著下降；ONS组和ONS+活性肽组患者体质量、BMI、肌肉量、体脂肪量、小腿围、腰围、臀围、握力水平、血清白蛋白、总蛋白水平明显高于入院时及对照组；ONS+活性肽组患者体质量、BMI、肌肉量、体脂肪量、血清白蛋白、总蛋白水平、小腿围较入院时有明显增长；与ONS组相比，ONS+活性肽组8周时患者蛋白质摄入明显增多，PG-SGA评分显著下降，差异均有统计学意义(P<0.05)。结论 肿瘤患者营养不良的风险较高，海洋生物活性肽联合常规ONS干预可能在改善肿瘤患者生活质量，延长生命中具有正面效应。更多还原

【Abstract】 Objective To explore the effect of marine bioactive peptides(MBP) combined with routine oral nutritional supplementation(ONS) on nutritional status in cancer patients, and to evaluate the effectiveness of nutritional support therapy. Methods A clinical randomized controlled trial was conducted on 108 patients with digestive tumors admitted in Shenzhen Hospital of Southern Medical University and the First Affiliated Hospital of Guangxi Medical University from September to November 2021. They were randomly divided into control group, ONS group and ONS+MBP group. All patients from the 3 groups received nutrition consultation and diet guidance to suggest balanced diet. ONS alone or combined with 18 g/d MBP were given to the patients of the ONS group and ONS+MBP group. The main observation indexes at admission and 8 weeks after intervention included NRS2002 score, PG-SGA score, body weight, body mass index(BMI), muscle mass, fat mass, upper arm muscle circumference, calf circumference, grip strength, and the secondary observation indexes included waist circumference, hip circumference, serum white blood cell count, red blood cell count, hemoglobin, albumin and total protein level. Results There were 36 patients from the control group, 33 from the ONS group and 30 from the ONS+MBP group completing the follow-up. No statistical differences were observed in the general clinical data among the 3 groups(P>0.05). After 8 weeks’ follow-up, NRS2002 and PG-SGA scores were increased, but body weight, BMI, fat mass, upper arm muscle circumference, calf circumference, waist circumference, hip circumference, grip strength and albumin level were decreased in the control group. The body weight, BMI, muscle mass, fat mass, calf circumference, waist circumference, hip circumference, grip strength, serum albumin and total protein levels at 8 weeks after intervention were significantly increased in the ONS group and ONS+MBP group than the levels at admission and those of the control group after 8 weeks’ follow-up. The ONS+MBP group also had obviously elevated body weight, BMI, muscle mass, fat mass, serum albumin and total protein levels and calf circumference when compared with those at admission. The patients of the ONS+MBP group showed significant increase in protein intake and notable decrease in PG-SGA score at 8 weeks(P<0.05). Conclusion Cancer patients have a high risk for malnutrition, and intervention of ONS combined with MAP may have positive effects on improving their quality of life and extend their lives.更多还原