不同营养评价方法在老年患者中的一致性研究  

Consistency study of different nutritional evaluation methods among elderly patients

作　　者：王帅[1] 李毅[1] 侯韦莲 胡世莲 Wang Shuai;Li Yi;Hou Weilian;Hu Shilian(Department of Clinical Nutrition,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,China;不详)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)临床营养科,合肥230001 [2]安徽省老年医学研究所

出　　处：《中国临床保健杂志》2023年第4期470-475,共6页Chinese Journal of Clinical Healthcare

基　　金：安徽省中央引导地方发展专项科研项目(2019b12030026)。

摘　　要：目的 探讨不同营养评价方法在老年患者中的应用价值。方法 分别应用微型营养评定(MNA)、主观整体评价法(SGA)、全球(营养)领导人营养不良倡议(GLIM)营养评价工具,对在2018年12月1日至2020年12月31日入住中国科学技术大学附属第一医院(安徽省立医院)老年医学科的308例患者进行营养评价,以MNA为评价“金标准”。结果 用GLIM、MNA、SGA对老年患者进行营养评价,营养良好的比例分别为72.08%(222/308)、56.49%(174/308)、62.01%(191/308),重度营养不良的比例分别是13.96%(43/308)、18.18%(56/308)、25.97%(80/308)。GLIM与“金标准”一致性较好,Kappa值为0.573,SGA的一致性较差,Kappa值仅为0.291。受试者工作特征曲线分析显示,体重指数、上臂围、小腿围、利手握力、前白蛋白对预测老年患者营养不良具有较高的诊断价值,曲线下面积分别为0.718、0.709、0.729、0.796、0.774,最佳截断值分别为21.21 kg/m2、22.50 cm、30.75 cm、22.50 kg、194.5 g/L。结论 GLIM、MNA对于老年患者营养评价应用价值较高,且一致性较好,可为临床对营养不良早期干预提供依据。Objective To explore the application value of different nutritional evaluation methods in elderly patients and to explore their consistency and accuracy.Methods The nutrition evaluation methods of mini-nutritional assessment(MNA),subjective global assessment(SGA),global leadership initiative on malnutrition(GLIM)were used to screen and evaluate the nutrition of 308 patients who were admitted to the geriatric department of the First Affiliated Hospital of University of Science and Technology of China from December 1,2018 to December 31,2020.Results The proportion of good nutrition was 72.08%(222/308),56.49%(174/308),62.01%(191/308),and the proportion of severe malnutrition was 13.96%(43/308),18.18%(56/308),25.97%(80/308).The consistency between glim and the"gold standard"was good,and the kappa values were 0.573.The consistency of SGA was poor,and the kappa value is only 0.291.ROC curve analysis showed that BMI,upper arm circumference,lower leg circumference,grip strength and prealbumin had high diagnostic value in predicting malnutrition in elderly patients.AUC areas were 0.718,0.709,0.729,0.796 and 0.774 respectively,and the best cut-off values were 21.21 kg/m 2,22.50 cm,30.75 cm,22.50 kg and 194.5 g/L respectively.Conclusions GLIM and MNA have high application value and good consistency for nutritional evaluation of elderly patients,they can provide basis for clinical early intervention of malnutrition.

关 键 词：营养评价 老年人营养生理学现象 营养不良 老年人 

分 类 号：R153.3[医药卫生—营养与食品卫生学]