NRS 2002和MNA-SF对老年住院患者营养不良风险筛查的应用比较

目的 探讨营养风险筛查2002 （nutritional risk screening 2002,NRS 2002）和微型营养评定法简版（min nutrition assessment short form,MNA-SF）对老年住院患者的营养不良风险筛查情况,并评价两种工具适用性.方法 采用定点连续抽样方法,选取2012年3月1日-2012年4月15日复旦大学附属华东医院外科（普外科、骨科、胸外科）和内科（消化内科、呼吸内科、心内科和神经内科）65岁及以上新入院患者,使用NRS 2002和MNA-SF两种方法评估营养风险,并进行问卷调查和体格检查.结果 410例患者中,内科、外科及总体的营养不良风险发生率NRS 2002分别为45.8％,46.4％,46.1％,MNA-SF分别为43.7％,41.9％,42.7％;总体营养不良风险发生率NRS 2002高于MNA-SF （P＜0.001）.单独使用NRS 2002和MNA-SF方法对于内外科营养不良风险检出发生率差异均无统计学意义（P分别为0.921,0.764）.单独使用BMI、Alb、CC均低估临床营养不良风险发生率.结论 老年住院患者的营养不良风险发生率均较高,NRS 2002和MNA-SF两种工具对于老年住院患者均适用.

Comparison on nutrition risk screening in elderly inpatients by NRS 2002 and MNA-SF

Objects To compare the application of NRS 2002 and MNA-SF in nutrition risk screening in elderly inpatients and to evaluate the applicability of the two tools.Methods Elderly inpatients in the department of surgery or in the department of internal medicine were selected by using successive sampling method.Eligible subjects were enrolled from March 1,2012 to April 15,2012.Their nutritional status were evulated by using NRS 2002 and MNA-SF screening at the same time.Results Four hundred and ten patients were enrolled.According to the standard of NRS 2002,the overall incidence of nutritional risk was 46.1％.The incidence of malnutrition risk in the department of internal medicine and in the department of surgery was 45.8 ％ and 46.4 ％,respectively.According to the standard of MNA-SF,the overall incidence of malnutrition risk is 42.7 ％.The incidence of malnutrition risk in the department of internal medicine and in the department of surgery was 43.7％ and 41.9％,respectively.There was significant difference in the overall incidence of malnutrition risk between the two methods （P ＜ 0.001）.There was no significant difference in detection rate of malnutrition risk between NRS 2002 and MNA-SF both in the department of internal medicine and in the department of surgery （P=0.921 and 0.764）.It would underestimate the malnutrition risk by using BMI、Alb、CC only.Conclusions The incidence of malnutrition risk in elderly inpatients was relatively high.Both NRS 2002 and the MNA-SF were suitable for elderly inpatients.