不同营养评价方法在肝病病人中的比较及适宜肝病营养评价的方法  

Comparison of different nutritional assessments and a try of a new method in nutritional assessment for liver disease

作　　者：于红卫[1] 侯维[1] 时淑云[1] 段忠辉[1] 李胜利[1] 刘菲菲[1] 李娟[1] 董金玲[1] 孟庆华[1] 

机构地区：[1]首都医科大学附属北京佑安医院肝病重症医学科,北京100069

出　　处：《肠外与肠内营养》2016年第2期82-86,共5页Parenteral & Enteral Nutrition

基　　金：北京市卫生和计划生育委员会科技成果和适宜技术推广项目(TG-2014-01)

摘　　要：目的:应用不同营养筛查/评估方法对肝病病人进行营养状况调查,筛选出新的适合肝病病人的营养评价方法。方法:选择慢性肝病住院病人525例,其中慢性肝炎149例,肝硬化360例,肝衰竭16例。应用主观全面评定法(SGA)、营养风险筛查NRS 2002、微型营养评价精法(MNA-SF)和传统营养指标的测定和比较,通过多因素分析筛选出适合慢性肝病病人的营养评价指标。结果:应用SGA法、MNA-SF法和上臂肌围(MAMC)、肱三头肌皮皱厚度(TSF)、血清清蛋白(ALB)、前清蛋白(PA)、淋巴细胞总数(LCT)指标评估营养状态时,不同疾病分组营养状况差异存在统计学意义(P<0.05)。TSF、MAMC、ALB和活动能力是影响慢性肝病病人发生感染、胸腹水、器官功能衰竭和进入ICU的危险因素,并以此建立肝病病人营养评价方法(NALD)。结论:应用NALD,更适合评价肝病病人的营养状况。Objective： To evaluate the nutrition status in patients with liver disease degree uesing different nutritional assessments. Methods： The object of study is 525 cases of hospitalized patients with chronic liver disease,149 cases with chronic hepatitis,360 cases with cirrhosis,and 16 cases with liver failure. Subjective comprehensive evaluation method（ SGA）,NRS 2002,mini nutritional assessment method（ MNA-SF） and traditional evaluation index were used to assess nutrition status. Results：Using different methods,the significant differences of nutritional status could be foud between different disease groups（ P〈0. 05）. TSF,MAMC,ALB and activity is the risk factors for the adverse events,such as infection,ascites,organ failure,and need to ICU in patients with chronic liver disease. A new nutritional evaluation method was more useful. Conclusion： There is no consistency in traditional nutrition evaluation method for patients with liver disease. Nutritional Assessment for Liver Disease（ NALD） was more suitable to assess nutritional status for patients with liver disease.

关 键 词：肝病 营养评价方法 营养筛查 

分 类 号：R575[医药卫生—消化系统] R459.3[医药卫生—内科学]