急性白血病患儿营养组分的临床分析

doi:10.7499/j.issn.1008-8830.2408102

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摘要目的评估不同阶段急性白血病（acute leukemia, AL）患儿人体成分的变化及面临的营养风险。方法应用生物电阻抗技术联合人体测量方法检测人体成分，前瞻性研究2023年8月—2024年7月山东省立医院不同阶段AL患儿和健康儿童的人体成分和身体均衡情况。结果 AL患儿和健康儿童的非脂肪成分均随年龄呈线性增长。在低年龄组中，AL患儿与健康儿童人体成分无明显差异；在高年龄组中，AL化疗中患儿的人体成分显著低于健康儿童（P<0.05），肌肉质量在AL化疗结束后首先恢复。AL结束化疗患儿躯干脂肪升高的患儿比例显著低于健康儿童（P<0.05），而身体左右严重不均的比例显著高于后者（P<0.05）。AL患儿肌肉分布以四肢不足和全身不足为主，健康儿童则以上肢不足为主。结论 AL患儿在不同治疗阶段人体成分有不同，提示营养状况受疾病本身及治疗的影响，早期筛查可为合理营养干预提供依据。

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	史立霞
	赵明忠
	王菲菲
	邢玉倩
	纪红燕
	赵平

关键词 ：急性白血病, 人体成分, 生物电阻抗, 营养风险筛查, 儿童

Abstract：Objective To assess the changes in body composition and nutritional risks faced by children with different stages of acute leukemia (AL). Methods Bioelectrical impedance analysis combined with anthropometric measurements was used to detect body composition. This prospective study was conducted from August 2023 to July 2024 at Shandong Provincial Hospital, examining the body composition and physical balance of children with various stages of AL and healthy children. Results The non-fat components of children with AL and healthy children both showed a linear increase with age. In the younger age group, there were no significant differences in body composition between children with AL and healthy children. However, in the older age group, the body composition of children undergoing chemotherapy for AL was significantly lower than that of healthy children (P<0.05), and muscle mass recovered first after the completion of AL chemotherapy. The proportion of children with increased trunk fat in AL children who completed chemotherapy was significantly lower than that in healthy children (P<0.05), while the incidence rate of severe left-right imbalance in body composition was significantly higher (P<0.05). Muscle distribution in children with AL primarily showed insufficient limb and overall muscle mass, whereas healthy children mainly exhibited insufficient upper limb muscle mass. Conclusions The body composition of children with AL varies at different treatment stages, indicating that nutritional status is affected by both the disease itself and the treatment. Early screening can provide a basis for reasonable nutritional intervention.

Key words： Acute leukemia Body composition Bioelectrical impedance Nutritional risk screening Child

收稿日期: 2024-08-20

基金资助:山东省自然科学基金（ZR2021MH336）；山东大学横断面研究项目（6020120012）。

通讯作者: 赵平，女，主任医师，教授。Email：slyyzp123@163.com。 E-mail: slyyzp123@163.com

作者简介: 史立霞，女，硕士研究生；

引用本文:

史立霞,赵明忠,王菲菲等. 急性白血病患儿营养组分的临床分析[J]. 中国当代儿科杂志, 2025, 27(3): 300-307.

SHI Li-Xia,ZHAO Ming-Zhong,WANG Fei-Fei et al. Clinical analysis of nutritional components in children with acute leukemia[J]. CJCP, 2025, 27(3): 300-307.

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