相位角联合去脂体重指数或相对四肢骨骼肌指数诊断围造血干细胞移植患者营养不良的价值  

Exploration of Phase Angel Combined with Fat Free Mass Index or Relative Appendicular Skeletal Muscle Index to Define Malnutrition of peri-Hematopoietic Stem Cell Transplantation Patients

作　　者：冯果[1] 刘红 王萌[1] 吴锦如[1] 刘华[2] 刘敏[1] 李成媛[3] FENG Guo;LIU Hong;WANG Meng(The Third Xiangya Hospital,Central South University,Changsha,410013)

机构地区：[1]中南大学湘雅三医院营养科,湖南长沙410013 [2]中南大学湘雅三医院供应室,湖南长沙410013 [3]中南大学湘雅三医院血液科,湖南长沙410013

出　　处：《医学临床研究》2021年第7期983-986,共4页Journal of Clinical Research

基　　金：湖南省卫生厅课题(B2014-037);湖南省科技厅科技计划项目(2011FJ3254)。

摘　　要：[目的]探讨相位角(PA)联合去脂体重指数(FFMI)或相对四肢骨骼肌指数(RAMS)对围造血干细胞移植期患者营养不良的诊断价值。[方法]对98例围造血干细胞移植期患者进行营养风险筛查(NRS2002),同时通过生物电阻抗法(BIA)测定其PA、FFMI或RAMS,并以GLIM标准诊断营养不良。通过Pearson相关性分析计算PA与FFMI或RAMS的相关性。以Logistic回归分析法计算得出98例患者的PA与FFMI结合因素、PA与RAMS结合因素数值,用ROC法分别检测PA、FFMI、RAMS、PA与FFMI结合因素、PA与RAMS结合因素诊断营养不良的曲线下面积(AUC)。[结果]围造血干细胞移植期患者NRS2002阳性率达100%;PA与FFMI和RAMS均存在强正相关性(P<0.01)。PA、FFMI、RAMS的AUC分别为0.308、0.204、0.270(均P<0.01),而PA与FFMI结合因素、PA与RAMS结合因素的AUC为0.791和0.737(P<0.01)。[结论]PA,FFMI和RAMS分别诊断营养不良的准确性较差,但PA与FFMI结合因素、PA与RAMS结合因素诊断营养不良的准确性较好,提示将PA与FFMI或RAMS结合或可为诊断营养不良提供依据。[Objective]This research is aimed to explore the significance of phase angle(PA)combined with fat-free body mass index(FFMI)or relative limb skeletal muscle index(RAMS)in the evaluation of malnutrition in peri-hematopoietic stem cell transplantation(HSCT)patients.[Methods]A total of 98 patients treated with HSCT were recruited for the study.The nutritional risk was assessed by Nutritional Risk Screening 2002(NRS2002)and malnutrition status was diagnosed according to standard of GLIM.PA,FFMI and.RAMS were tested by Bio Impedance Analysis(BIA).Correlations among PA,FFMI and RAMS were analyzed by Pearson analysis.The combined data of PA and FFMI and combined data of PA and RAMS of 98 patients were calculated by Logistic analysis.The ROC analysis was used to detect the area under the curve(AUC)of PA,FFMI,RAMS,PA combined with FFMI,and PA combined with RAMS.[Results]The positive rate of NRS2002 in peri-hematopoietic stem cell transplantation patients was 100%.It showed the strong positive relationship of PA with FFMI and PA with RAMS(P<0.01).Using GLIM criteria as the standard for the diagnosis of malnutrition,the area under the ROC curve of PA,FFMI,and RAMS were 0.308,0.204 and 0.270,respectively(P<0.01).The area under the ROC curve of the combined data of PA and FFMI and the combined data of PA and RAMS were 0.791 and 0.737(P<0.01).[Conclusion]PA,FFMI and RAMS alone have poor accuracy in diagnosing malnutrition,but the combined data of PA and FFMI and the combined data of PA and RAMS are more accurate in diagnosing malnutrition.It is suggested that combining PA with FFMI and PA with RAMS may provide evidence for malnourished diagnosis.

关 键 词：造血干细胞移植 肌营养不良/诊断 肌 骨骼/生理学 人体质量指数 

分 类 号：R746.2[医药卫生—神经病学与精神病学]