修订版微型营养评价简表在内科老年住院病人中的应用评价  

Validation of the revised mini nutritional assessment short-forms in geriatric internal medicine patients

作　　者：曲正 张华明 郭享 关英俊 QU Zheng;ZHANG Hua-ming;GUO Xiang;GUAN Ying-jun(Department of Gastroenterology;Department of Radiology;Department of Nutrition, Shanghai Zhongye Hospital, Shanghai 200941, China)

机构地区：[1]上海中冶医院消化内科,上海200941 [2]上海中冶医院放射科,上海200941 [3]上海中冶医院营养科,上海200941

出　　处：《肠外与肠内营养》2018年第1期20-23,共4页Parenteral & Enteral Nutrition

摘　　要：目的:评价修订版微型营养评价简表(MNA~?-SF)在内科住院老年病人中的应用效果。方法:分别采用MNA~?-SF、full MNA~?评估105名内科住院老年病人的营养状况,分析两者相关性、一致性。结果:BMI-MNA-SF和CC-MNA-SF两种评估方法与full MNA~?高度正相关(r分别为0.908,0.8381,P<0.001)。一致率分别为83.81%,68.57%。根据full MNA~?的分级标准,分别按MNA≥24分、MNA≥17分二分类分组,BMIMNA-SF的敏感性、特异度、阳性预测值、阴性预测值、约登指数均较高,CC-MNA-SF的大部分指标稍低于BMIMNA-SF。在前一分组中BMI-MNA-SF和CC-MNA-SF曲线下面积(95%可信区间)分别为0.951(0.916,0.985)、0.938(0.894,0.983);后一分组中分别为1.000(1.000,1.000)、0.985(0.963,1.000),P<0.001。BMI-MNA-SF和CCMNA-SF均未漏诊"营养不良"。结论:对于内科老年住院病人,BMI-MNA-SF和CC-MNA-SF都是简洁、有效的营养筛查工具,在BMI不易获得的情况下,CC-MNA-SF是可靠的选择。Objective： To validate the revised BMI-MNA-SF and CC-MNA-SF with regard to association and agreement with the full MNA, considered as gold standard, in geriatric internal medicine patients. Methods： 105 cases of hospitalized elderly patients in internal medicine were recruited for the study. The nutritional status correlation and coherence were evaluated with the revised BMI-MNA-SF CC-MNA-SF and the full MNA, respectively. Results： The BMI-MNA-SF and CC-MNA-SF all correlated strongly with the full MNA （Pearson＇s correlation coefficient r=0.9080,0.8381 respectively ; P 〈 0.001）. High values of sensitivity, specificity and predictive values were observed for the BMI-MNA-SF and CC-MNA-SF against the full MNA~ as the dichotomized categorizations ＂malnourished-at risk of malnutrition＂ vs ＂well nourished＂ and ＂malnourished＂ vs ＂at risk of malnutrition-well nourished＂ were considered. Most of values of those for CC-MNA-SF are lower slightly than BMI-MNA-SF. Areas under the ROC curves also reached high values （BMI- MNA-SF： 0.951 and CC-MNA-SF： 0.938 for the first categorization ; BMI-MNA-SF ： 1.000 and CC- MNA-SF ： 0.985 for the second one） showing both tests excellent accuracy with the full-MNA. The agreement between the MNA-SFs and the full-MNA was quantified as the percentage of correct classifications. The BMI-MNA- SF classified 83.81% ,correctly and the CC-MNA-SF classified 68.57 % correctly. Malnutrition proportions of subjects were not underestimated by both MNA-SFs. Conclusion： The revised BMI-MNA-SF and CC-MNA-SF are rapid, easy and reliable tools are capable to identify malnourished individuals in internal medicine and those who are at risk of malnutrition. Due to the special characteristics of elderly patients, the CC-MNA-SF is a good option to replace the BMI-MNA-SF when BMI is not available.

关 键 词：微型营养评价法 修订版微型营养评价简表 老年人 住院 内科 

分 类 号：R151.42[医药卫生—营养与食品卫生学]