简略版PG-SGA(PG-SGA SF)对肝癌病人营养评估价值  

The role of PG-SGA SF in evaluating the perioperative nutritional status of patients with liver cancer

作　　者：李春蕾 曾亚奇 张萍 董杰 陈亚军 李玥莹 王昆 LI Chun-lei;ZENG Ya-qi;ZHANG Ping;DONG Jie;CHEN Ya-jun;LI Yue-ying;WANG Kun(Department of Nutrition,Tianjin Medical University Cancer Hospital,National Clinical Research Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin's Clinical Research Center for Cancer;Department of Pain Management,Tianjin Medical University Cancer Hospital,Tianjin 300060,China)

机构地区：[1]天津医科大学肿瘤医院营养科/国家肿瘤临床医学研究中心/天津市肿瘤防治重点实验室/天津市恶性肿瘤临床医学研究中心 [2]天津医科大学肿瘤医院疼痛科,天津300060

出　　处：《肠外与肠内营养》2019年第5期266-270,共5页Parenteral & Enteral Nutrition

基　　金：天津医科大学肿瘤医院院级课题肿瘤转化医学种子基金(项目编号：1712)

摘　　要：目的:比较简略版患者主观评估量表(PG-SGA SF)与完整版PG-SGA在肝癌营养评估中的有效性。方法:本研究是前瞻性观察性研究,选取接受肝脏切除术的肝癌病人。使用PG-SGA、PG-SGA SF、NRS 2002、握力、皮褶厚度和生化检验等评估围术期病人的营养状况。以PG-SGA完整版为标准绘制ROC曲线,评估不同简略版评估方式的组合,并分析最佳截断值的灵敏度和特异度等。结果:共纳入88例原发性肝癌病人。结果显示,以Boxes1,2,3,4(简称Boxes1-4)判定营养不良时,ROC曲线下面积为0.986,截断值为6分,灵敏度为1,特异度尚可为0.833;Boxes1+3判定营养不良时,截断值为3分,曲线下面积为0.985,灵敏度和特异度为1、0.798,省略Box2和Box4后对评估能力影响小。结论:肝胆外科应用PG-SGA SF评估与完整版有相近的信度和效度,是一种简便、有实用价值的营养评估工具,应用Boxes1+3可节约时间并得到满意的评估结果。Objective:The aim of the study was to evaluate the efficacy of Patient-Generated Subjective Global Assessment Short Form(PG-SGA SF)and PG-SGA in the assessment of nutritional status of patients with liver cancer.Methods:This was a prospective observational study which included patients undergoing liver resection.Nutritional status of patients were assessed according to PG-SGA,PG-SGA SF,NRS-2002,grip strength,skinfold thickness,and biochemical tests.Results:Eighty-eight patients undergoing liver resection were included.Malnutrition was determined by Boxes1,2,3,4(referred as Boxes1-4),the area under the ROC curve was 0.986,the cutoff value was 6,the sensitivity was 1 and the specificity was 0.833.However,if malnutrition was judged by Boxes1,3(Boxes 1+3),the cutoff value was 3,the area under the combination curve was 0.985,the sensitivity and specificity was 1 and 0.798.Omitting Box2 and Box4 had limited impact on the evaluation validity.Conclusion:Using PG-SGA SF,which is a simple and practical nutritional assessment tool,in hepatobiliary surgery,had similar reliability and validity to the full version.Boxes1+3 can save time and get satisfactory evaluation results.

关 键 词：营养评估 PG-SGA 简略版PG-SGA 肝癌 

分 类 号：R151.42[医药卫生—营养与食品卫生学] R735.7[医药卫生—公共卫生与预防医学]