握力在老年内科住院患者营养评价中的应用价值  

Application value of handgrip strength in nutrition assessment of elderly medical inpatients

作　　者：张新胜[1] 刘英华[1] 张永[1] 徐庆[1] 于晓明[1] 王觐[1] 杨雪艳[1] 刘钊[1] 薛长勇 

机构地区：[1]解放军总医院营养科,北京100853

出　　处：《解放军医学院学报》2015年第8期818-821,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的探讨握力(handgrip strength,HGS)在老年内科住院患者营养评价中的价值。方法我院于2012年5月-2013年12月采用连续定点抽样,对新入院老年患者1 343例进行微型营养评价精法(mini nutritional assessment short-form,MNA-SF)评估营养状况,测量HGS、身高、体质量、体质量指数(body mass index,BMI)、腰围(waist circumference,WC)、小腿围(leg circumference,LC)及收集血红蛋白(hemoglobin,HB)、总蛋白(total protein,TP)、白蛋白(albumin,ALB)、肌酐(creatinine,Cr)、尿素氮(blood urea nitrogen,BUN)、三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)等指标。分析HGS的相关影响因素及判断营养不良的临界值。结果老年内科住院患者MNA-SF评估显示营养不良构成比为39.99%(男40.49%、女39.51%);存在营养不良的老年内科住院患者的HGS、体质量、BMI、WC、LC、ALB、TG及HB均较营养正常组人群偏低,而年龄偏高(P<0.05)。相关分析显示,优势手握力与MNA-SF评估结果有显著相关性(P<0.05),与身高、体质量、BMI、WC、LC、ALB、TP、TG、HB均呈显著正相关(P<0.05),而与年龄呈显著负相关(P<0.05)。优势手握力预测老年内科住院患者营养状况的ROC曲线下面积>0.7(P<0.05),男性患者的优势手握力<20.8 kg,女性<16.1 kg可以判断存在营养不良。结论老年内科住院患者营养不良比例较高,HGS测量简单易行且经济,可用于评估老年内科住院患者的营养状况。Objective To assess the application value of handgrip strength in nutrition assessment of elderly medical inpatients. Methods A cross-sectional study was conducted in our hospital from May 2012 to December 2013, and 1343 patients were assessed by mini nutritional assessment short-form（MNA-SF） and their blood biochemical indicators in the 24 hours of admission, including HGS, height, weight, BMI, WC, LC, HB, TP, ALB, Cr, BUN, TG and TC, were measured. The correlation between HGS and nutritional indicators was analyzed and the dominant HGS cut points for malnutrition was estimated. Results Of all the elderly inpatients, 39.99% of them（men 40.49%, women 39.51%） had malnutrition by MNA-SF; The HGS, weight, BMI, WC, LC, ALB, TG and HB of malnutrition group were significantly lower than those of well nutrition group, but the age was significantly higher（P〈0.05）; Pearson＇s correlation analysis showed that the dominant HGS was correlated with MNA-SF result（P〈0.05）, and positively correlated with height, weight, BMI, WC, LC, ALB, TP, TG and HB（P〈0.05）, and negatively correlated with age（P〈0.05）. ROC curve analysis for dominant HGS and nutritional status sensitivity/specificity found that the area under the curve was more than 0.7, and the dominant HGS cut points for malnutrition were 20.8 kg for men and 16.1 kg for women by MNA-SF. Conclusion Elderly inpatients are associated with a greater incidence of malnutrition. HGS is a rapid, cost-effective and easy-to-use method, which is suitable for assessing nutritional status of elderly medical inpatients.

关 键 词：握力 老年住院患者 营养评价 微型营养评价精法 营养不良 

分 类 号：R153.3[医药卫生—营养与食品卫生学]