预后营养指数与微型营养评估表评价老年急性脑梗死患者营养不良效果的对比分析  

Comparative analysis of prognostic nutritional index and mini-nutrition assessment form in evaluating effects of malnutrition in elderly patients with acute cerebral infarction

作　　者：崔玉环[1] 张婧文 徐雅丽 冯英慧[1] 杜丹 颜娟[2] 连晶晶[3] 刘占矿[1] 董利平[1] CUI Yuhuan;ZHANG Jingwen;XU Yali;FENG Yinghui;DU Dan;YAN Juan;LIAN Jingjing;LIU Zhankuang;DONG Liping(Department of Geriatrics,First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Pharmacy,First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Clinical Laboratory,First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院老年病科,河北张家口075000 [2]河北北方学院附属第一医院药学部,河北张家口075000 [3]河北北方学院附属第一医院检验科,河北张家口075000

出　　处：《重庆医学》2022年第9期1530-1535,共6页Chongqing medicine

基　　金：2020年度河北省卫健委医学科学研究课题计划(20200560);2018年张家口市科学技术和地震局项目(1821042D)。

摘　　要：目的利用微型营养评估表(MNA)评估预后营养指数(PNI)评价老年急性脑梗死患者营养状况的功效。方法收集120例老年急性脑梗死患者基线资料,以MNA判定的营养不良或风险作为效标绘制PNI受试者工作曲线(ROC),确定PNI最佳截断值并分组。再应用MNA和PNI两种方法对患者进行营养评估,并与人体测量学、生物化学、功能评估等参数进行相关性比较。最后评价两种方法的一致性。结果PNI最佳截断值为50.625。120例患者中MNA评估为营养不良或营养不良风险者57例(47.5%),PNI评估为营养不良或营养不良风险者51例(42.5%)。在评估老年急性脑梗死患者营养状态时,MNA与PNI在年龄、体重、手臂围、小腿围、体重减轻、体重指数、美国国立卫生研究院卒中量表(NIHSS)评分及淋巴细胞总数、总蛋白参数上无显著差异。两种方法一致性验证中,PNI与MNA具有高度一致性(κ=0.664)。结论PNI和MNA在评估老年急性脑梗死患者营养状态中具有高度一致。Objective To use the verified tool Mini Nutrition Assessment Form(MNA)to evaluate the efficacy of Prognostic Nutrition Index(PNI)in detecting the nutritional status of elderly patients with acute cerebral infarction.Methods The baseline data of 120 patients with acute cerebral infarction were collected,the PNI receiver operating characteristic(ROC)curve was drawn with malnutrition or risk determined by MNA as the criterion,the optimal cutoff value of PNI was determined and the grouping was performed.The two methods of MNA and PNI were applied to conduct the nutritional assessment on the patients,which with the parameters such as anthropometry,biochemistry and function evaluation conducted the correlation comparison.Results The optimal cut off value of PNI was 50.625.Among 120 cases,57 cases(47.5%)were evaluated as malnutrition or at risk by MNA,and 51 cases(42.5%)were evaluated as malnutrition or at risk by PNI.In assessing the nutritional status of acute cerebral infarction in the elderly,both MNA and PNI methods had no significant differences in the age,body weight,arm circumference,calf circumference,weight loss,body mass index,National Institutes of Health Stroke Scale(NIHSS)score and the total number of lymphocytes and total albumin.In the consistency validation of the two methods,PNI and MNA had high consistency(κ=0.664).Conclusion PNI and MNA are highly consistent in assessing the nutritional status of elderly patients with acute cerebral infarction.

关 键 词：脑梗死 营养筛查 预后营养指数 微型营养评估表 

分 类 号：R743.32[医药卫生—神经病学与精神病学]