精简微型营养评价量表预测老年慢性阻塞性肺疾病患者急性加重风险的效能评价  

Efficacy of mini nutritional assessment short-form in predicting the risk of acute exacerbation in old chronic obstructive pulmonary disease patients

作　　者：高士媛 施敏骅[1] 陈锐[1] 吴兴贵 邢玉斐[1] 陈婷[1] 连一新[1] Gao Shiyuan;Shi Minhua;Chen Rui;Wu Xinggui;Xing Yufei;Chen Ting;Lian Yixin(Department of Respiratory Medicine,the Second Affiliated Hospital of Soochow University,Suzhou 215004,China)

机构地区：[1]苏州大学附属第二医院呼吸内科,苏州215004

出　　处：《中华医学杂志》2020年第14期1063-1067,共5页National Medical Journal of China

基　　金：苏州市医学重点学科(Szxk201506)。

摘　　要：目的评价精简微型营养评价量表(MNA-SF)预测老年慢性阻塞性肺疾病(简称慢阻肺)急性加重风险的效能。方法收集2017年1月至2019年5月于苏州大学附属第二医院呼吸科进行随访的202例稳定期慢阻肺患者的临床资料,根据患者上一年的急性加重史分为急性加重高风险组及急性加重低风险组,评估各患者的MNA-SF评分并进行分析。将发生慢阻肺急性加重的风险高低作为因变量,对相关风险因素进行Logistic回归分析建立预测模型,并应用受试者工作特征(ROC)曲线评价该模型预测老年慢阻肺患者急性加重风险的准确度、灵敏度和特异度。结果202例慢阻肺患者分为急性加重高风险组131例(64.9%)和急性加重低风险组71例(35.1%)。急性加重高风险组MNA-SF评分显著低于低风险组[(9.4±2.1)比(11.6±1.9)分](P<0.001)。二元Logistic回归分析显示MNA-SF评分[OR=0.556(95%CI:0.445~0.695),P<0.05]是老年慢阻肺患者急性加重风险的独立影响因素,获得预测模型为Logit(P)=4.413-0.586×MNA-SF评分。该模型对慢阻肺急性加重风险判断的准确率为77.4%,灵敏度为79.7%,特异度为72.1%。结论MNA-SF能够较好地预测老年慢阻肺患者的急性加重风险。Objective To evaluate the diagnostic efficacy of Mini Nutritional Assessment Short-form (MNA-SF) in predicting acute exacerbation of old chronic obstructive pulmonary disease (COPD) patients.Methods The clinical data and Nutritional assessment of 202 outpatients who were given treatment in the Second Affiliated Hospital of Soochow University from January 2017 to May 2019 were analyzed. According to the frequency of acute exacerbation in the last year, patients were divided into high-risk group and low-risk group. The dependent variable was the risk of the acute exacerbation of COPD while the predicting model was established by using multivariate Logistic regression. Finally, the accuracy, sensitivity and specificity of the model was evaluated by the receiver operating characteristic (ROC) curve.Results Among the 202 COPD patients, 131 patients (64.9%) were brought into the high-risk group and 71 patients (35.1%) were brought into the low-risk group. MNA-SF scores in high-risk group were significant lower than those in low-risk group [(9.4±2.1) vs (11.6±1.9), P<0.001]. The logistic regression analysis showed that MNA-SF score [OR=0.556(95%CI: 0.445-0.695), P<0.05] was an independent factor of acute exacerbation. The obtained model was Logit(P)=4.413-0.586×MNA-SF scores. The accuracy of model for the risk of the acute exacerbation of COPD was 77.4%, with a sensitivity of 79.7%, a specificity of 72.1%.Conclusion MNA-SF is qualified for predicting the acute exacerbation of COPD patients in stable stage.

关 键 词：肺疾病 慢性阻塞性 营养评价 预测 

分 类 号：R563[医药卫生—呼吸系统]