简化营养评分应用于老年严重肢体缺血病人的营养筛查  

Application of simplified nutritional screening index in elderly patients with critical limb ischemia

作　　者：许田田 谢丽 何春水[2,3] 刘洋 张丽峰[2] 刘芯君[2] 邱婷婷[2] XU Tian-tian;XIE Li;HE Chun-shui;LIU Yang;ZHANG Li-feng;LIU Xin-jun;QIU Ting-ting(Chengdu University of Traditional Chinese Medicine,Chengdu 610072,Sichuan,China;Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610032,Sichuan,China;Chengdu Shangyi Information Technology Co.,Ltd,Chengdu 610094,Sichuan,China)

机构地区：[1]成都中医药大学,四川成都610072 [2]成都中医药大学附属医院,四川成都610032 [3]成都尚医信息科技有限公司,四川成都610094

出　　处：《肠外与肠内营养》2022年第1期7-12,共6页Parenteral & Enteral Nutrition

摘　　要：目的:运用老年营养风险指数(GNRI)和控制营养状态评分(CONUT)评估老年严重肢体缺血(CLI)病人的营养状况,探讨老年CLI病人的营养状况以及GNRI和CONUT的应用价值。方法:选取2016年1月至2021年5月入院进行血管腔内治疗(EVT)的107名年龄≥55岁的CLI病人为研究对象,根据GNRI评分对病人进行营养分级,分为中高、低和无风险组,根据CONUT评分分为中重度、轻度和正常组。分析营养指标与营养评分的相关性。结果:107名病人中,根据GNRI评分,中高、低、无风险组病人分别占33%、22%和45%;中高组病人HGB、CHOL、LDL-C、TG和PA显著低于无风险组病人,中高组的TG和PA也明显小于低组,差异有统计学意义(P<0.05)。而CONUT评分中,中重度、轻度组和正常组病人分别占20%、51%和29%。中重度组的HGB、LDL-C、PA明显低于正常组和轻度组的病人,中重度组的TG和HDL-C显著低于正常组,差异有统计学意义(P<0.05)。基于GNRI和CONUT评分发现GNRI的两组病人在慢性肾衰竭(CKD 4-5)的患病率上有明显差异(P<0.05),其余临床特征无明显差异(P>0.05)。相关性分析结果显示,CONUT评分与HGB、TG、HDL-C、LDL-C,PA呈负相关,与Cre呈正相关。GNRI与HGB、CHOL、TG、LDL-C以及PA呈正相关(P<0.05)。结论:临床工作者应该重视对CLI病人的营养筛查,GNRI和CONUT是便捷有效的营养筛查工具,值得推广到临床应用。Objective:The nutritional status of elderly patients with severe limb ischemia(CLI)was evaluated by Geriatric nutritional risk index(GNRI)and controlled nutritional status Score(CONUT),and the effect of GNRI and CONUT for nutritional screening was investigated in the patients with CLI.Methods:A total of 107 CLI patients aged≥55 years who were hospitalized for endovascular therapy(EVT)in our hospital from January 2016 to May 2021were included as the research objects.According to GNRI score,the patients were divided into moderate and severe,low,and no nutritional related risk groups.According to CONUT score,the patients were divided into moderate and severe,mild and normal groups.The correlation between nutritional indicators and nutritional scores was explored.Results:Among the 107 patients,using scores for GNRI,45%,22%,and 33% patients were no nutritional related risk in the low and moderate and severe group,respectively;HGB,CHOL,LDL-C,TG and PA were significantly lower in the patients with moderate and severe malnutrition than those in the no risk group,TG and PA in the moderate and severe group were significantly lower than those in the low group.According to CONUT,patients were classified 20% as moderate and severe,29% as mild,51% as normal group.The HGB、LDL-C and PA of the moderate and severe patients were significantly lower than those of the normal and mild patients;TG and HDL-C of the moderate and severe patients were significantly lower than those of the normal patients(P<0.05).The clinical characteristics of CLI patients with or without nutritional risk were compared.It was found that there was a significant difference in the prevalence of chronic renal failure(CKD4-5)between the two groups based on GNRI(P<0.05),and others had no significant difference(P>0.05).The results of correlation analysis were that HGB,TG,HDL-C,LDL-C,PA were negatively correlated with CONUT score,Cre was positively correlated with CONUT score.HGB,CHOL,TG,LDL-C and PA were positively correlated with GNRI(P<0.05).Conclusion:Clin

关 键 词：老年营养风险指数 控制营养状态评分 严重肢体缺血 营养筛查 

分 类 号：R459.3[医药卫生—治疗学] R654.4[医药卫生—临床医学]