营养评定工具NRS2002、MNA和实验室检查在老年住院病人营养调查中的应用  

Application of Nutritional Risk Screening 2002,Mini Nutritional Assessment,and clinical laboratory measurements in nutrition survey of hospitalized elderly patients

作　　者：严凤琴[1] 朱虹[1] 段晓宇[1] 明小燕[1] 吴钦钦[1] 贺映侠 卜晓芬 胡红玲[1] 张婷婷[1] YAN Feng-qin ZHU Hong DUAN Xiao-yu MING Xiao-yan WU Qin-qin HE Ying-xia BU Xiao-fen HU Hong-ling ZHANG Ting-ting(Department of Comprehensive, The Centre Hospital of Wuhan City, Wuhan 430014 ,Hubei, China)

机构地区：[1]武汉市中心医院综合二科,湖北武汉430014

出　　处：《肠外与肠内营养》2016年第6期369-372,376,共5页Parenteral & Enteral Nutrition

摘　　要：目的:通过对老年住院病人进行营养筛查,为进一步营养支持治疗提供参考信息。方法:选取在我院住院≥70岁的老年病人119例,采用营养风险筛查(NRS 2002)和微型营养评定(MNA)分别评定病人的营养风险和营养状况,同时记录入院时病人的年龄、体质量指数(BMI)、消化功能、有无感染等基本信息,以及前清蛋白、清蛋白、血红蛋白、淋巴细胞计数、总胆固醇、三酰甘油、肌酐、尿素氮、血清铁等实验室检验指标。结果:1NRS 2002评估结果为"营养风险"的老年病人有21例,占17.6%;MNA评估结果为"营养不良风险或营养不良"的老年病人共有42例,占35.3%。2在上述调查中有营养风险的老年病人入院时BMI、前清蛋白、清蛋白、血红蛋白均明显低于无营养风险组。3在上述检测指标中,清蛋白与NRS 2002或MNA的相关性均优于其他指标,且其灵敏性和特异性均较高。结论:NRS 2002和MNA均可用于评定老年病人的营养状况,BMI、前清蛋白、清蛋白、血红蛋白也可用于辅助评定老年病人的营养状况。在无条件行营养工具筛查时,清蛋白是最佳的营养评定指标。Objective： To provide reference information for further nutrition support treatment through nutritional risk screening in elderly hospitalized patients. Methods： One hundred nineteen hospitalized elderly patients （ ≥ 70） were enrolled. At admission, patients were assessed for the following items： NRS 2002, MNA, demographic information such as age, body mass index, digestive function and infection, and laboratory values including prealbumin, albumin, hemoglobin, lymphocyte count, total cholesterol, triglyceride, serum creatinine, blood urea nitrogen, and serum iron. Results： ①There were 21 elderly patients evaluated as ＂ in need of nutritional support＂ by NRS 2002, accounting for 17.6%. A total of 42 elderly patients were evaluated as ＂risk of malnutrition or malnutrition＂ by MNA, accounting for 35.3%. ②The levels of BMI, prealbumin, albumin, and hemoglobin of elderly patients with nutritional risks were significantly lower than those without nutritional risk. ③The correlation between albumin and NRS 2002 or MNA was better than other parameters, and the sensitivity and specificity were superior. Conclusion ： The elderly inpatients have a high incidence of nutritional risk. Nutritional assessment tools such as NRS 2002 and MNA can be used to evaluate the nutritional status of elderly patients. Other commonly used indicators such as body mass index （ BMI）, prealbumin, albumin, and hemoglobin can also be used. The albumin is the best nutritional assessment indicator when no nutritional screening tools can be applied.

关 键 词：老年人 营养调查 营养风险 

分 类 号：R151.42[医药卫生—营养与食品卫生学] R59[医药卫生—公共卫生与预防医学]