不同评分工具筛查老年慢性阻塞性肺疾病患者营养风险的价值及与TSF、Alb、PA和Hb的关系  

Screening value of different scoring tools in nutritional risk and their relationship with TSF,Alb,PA and Hb in elderly patients with COPD

作　　者：洪小婷 程文[1] 张正国[1] HONG Xiaoting;CHENG Wen;ZHANG Zhengguo(Department of Respiratory and Critical Care Medicine,Huangshan People′s Hospital,Huangshan,Anhui 245000,China)

机构地区：[1]黄山市人民医院呼吸与危重症医学科,安徽黄山245000

出　　处：《临床肺科杂志》2025年第4期581-586,共6页Journal of Clinical Pulmonary Medicine

基　　金：黄山市科技计划管理项目(2019Z-03)。

摘　　要：目的研究不同评分工具筛查老年慢性阻塞性肺疾病(慢阻肺)患者营养风险的价值及与TSF、Alb、PA和Hb的关系。方法选取2023年4月-2024年6月于我院住院的140例慢阻肺患者为研究对象。以营养不良评定(诊断)标准共识(GLIM)为评定标准,考察微型营养评定简表(MNA-SF)、老年营养风险指数(GNRI)和老年人营养量表(NUFFE)在老年慢阻肺患者营养风险筛查中的应用价值,分析MNA-SF和GNRI、NUFFE与传统营养不良指标TSF、Alb、PA和Hb的相关性。结果MNA-SF评分筛查结果显示,灵敏度79.41%(81/102),特异度73.68%(28/38),准确率77.86%(109/140);GNRI评分筛查结果显示,灵敏度86.27%(88/102),特异度76.32%(29/38),准确率83.57%(117/140);NUFFE评分筛查结果显示,灵敏度81.37%(83/102),特异度71.05%(11/38),准确率78.57%(110/140);一致性检验结果显示,GNRI与GLIM标准的一致性最高(Kappa=0.601),优于NUFFE(Kappa=0.492)和MNA-SF(Kappa=0.487);MNA-SF<11分组TSF、Alb、PA和Hb水平均低于MNA-SF≥11分组,差异有统计意义(P<0.05);GNRI≤98组TSF、Alb、PA和Hb水平均低于GNRI>98组,差异有统计意义(P<0.05);NUFFE≥6分组TSF、Alb、PA和Hb水平均低于NUFFE<6分组,差异有统计意义(P<0.05);GNRI评分、MNA-SF与各指标呈正相关,NUFFE评分与各指标呈负相关(P<0.05)。结论GNRI评分、MNA-SF评分和NUFFE评分对于老年慢阻肺患者营养风险均具有一定的筛查价值,且GNRI营养风险筛查具有更高的效能。Objective To study the screening value of different scoring tools in nutritional risk and their relationship with TSF,Alb,PA and Hb in elderly patients with chronic obstructive pulmonary disease(COPD).Methods A total of 140 patients with COPD admitted to the hospital were enrolled as the research objects from April 2023 to June 2024.Taking global leadership initiative on malnutrition(GLIM)as evaluation criteria,screening value of mini nutrition assessment short form(MNA-SF),geriatric nutritional risk index(GNRI)and the nutritional form for the elderly(NUFFE)for nutritional risk was investigated.The correlation between MNA-S,GNRI,NUFFE and TSF,Alb,PA,Hb was analyzed.Results The sensitivity,specificity and accuracy of MNA-SF,GNRI and NUFFE for screening nutritional risk were[79.41%(81/102),73.68%(28/38),77.86%(109/140)],[86.27%(88/102),76.32%(29/38),83.57%(117/140)]and[81.37%(83/102),71.05%(11/38),78.57%(110/140)],respectively.The consistency test results showed that GNRI had the highest consistency with GLIM standard(Kappa=0.601),which was better than NUFFE(Kappa=0.492)and MNA-SF(Kappa=0.487).The levels of TSF,Alb,PA and Hb in the NAA-SF<11 group were lower than those in the NAA-SF≥11 group(P<0.05).The levels of TSF,Alb,PA and Hb in the GNRI≤98 group were lower than those in the GNRI>98 group(P<0.05).The levels of TSF,Alb,PA and Hb in the NUFFE≥6 group were lower than those in the NUFFE<6 group(P<0.05).GNRI score and MNA-SF were positively correlated with each index,while NUFFE score was negatively correlated with each index(P<0.05).Conclusion GNRI MNA-SF and NUFFE scores all have certain screening value for nutritional risk in elderly patients with COPD,and GNRI has higher sensitivity.

关 键 词：慢性阻塞性肺疾病 营养风险 营养风险筛查2002 老年营养风险指数评分 

分 类 号：R563.9[医药卫生—呼吸系统]