微型营养评定法在恶性肿瘤病人中的应用

为探讨微型营养评定法 (MNA)在恶性肿瘤病人的营养状况评价中的价值 ,测定 2 6 2例恶性肿瘤病人的MNA总分、身高、体重、年龄、体力状况、血液血红蛋白量 (Hb)、红细胞数 (RBC)、血清白蛋白浓度 (Alb)、血清前白蛋白浓度 (PA)。计算实际体重 健康时平时体重比 (UBW % )。根据MNA总分评价病人营养状况 :营养不良组 (MNA总分 <17) ;营养不良危险组 (MNA总分介于 17～ 2 3 5 ) ;营养良好组 (MNA总分≥ 2 4)。结果显示 :MNA总分与UBW %、Alb、PA、BMI值呈显著相关 (r=0 5 0 1～ 0 72 4,P =0 0 0 0 )。MNA与UBW %、BMI、PA、Alb方法评价病人的营养状况有良好的一致性 ,符合率分别为 82 %、76 %、71%、6 8%。根据MNA方法评价全组病人 ,营养不良者占 31 7% (83 2 6 2例 ) ,营养不良危险者占 2 5 9% (6 8 2 6 2例 ) ,营养良好者占 42 4%(111 2 6 2例 ) ;营养不良与营养不良危险的发生率无显著性差异 ;老年与非老年患者营养不良发生率无明显差异。胃癌、肝癌的营养不良发生率明显高于肺癌 (P =0 0 0 1)。体力状况越差 (ECOG分级越高 )、营养不良发生率越高。贫血患者营养不良发生率明显高于非贫血者。感染患者营养不良发生率明显高于非感染者。结果提示 ,MNA对于恶性肿瘤患者具有良好的营养评价作用。胃癌?

Measurement of nutritional status in oncological patients by mini nutritional assessment

To explore the Mini Nutritional Assessment(MNA) for evaluating nutritional status in the patients with cancer. The patient's MNA score ,height ,body weight,age, performance status,hemoglobin(HB), blood erythrocyte(RBC), and serum albumin concentration(Alb), and serum prealbumin concentrations(PA) were measured in 262 cancer patients. UBW% is the actual body weight / usual body weight (kg)×100%.The patients, nutritional status was judged by MNA score in following three categories: malnutrition(MNA score<17), at risk of malnutrition(MNA score 17-23.5), and adequate nutritional status (MNA score≥24).The results of nutritional status assessed by MNA were rather in accordance with BMI, UBW%, Alb and PA, respectively. 82%, 76%, 71% and 68% of the patients with nutritional status defined by MNA are agreed with those with same nutritional status assessed by UBW%, BMI, PA and Alb, respectively. MNA score significantly correlated with BMI,UBW%, serum Alb concentrations and serum PA concentrations (r=0.501-0.724, P=0.000). In all the patients, the incidence of patients with malnutrition according to MNA score was 31.7%. Risk of malnutrition was 25.9%. Adequate nutritional status was 42.4%,respectively. There were no significant differences in the incidence of malnutrition between the elderly patients and youngers' judged by MNA. The incidence of patients with malnutrition in gastric carcinoma or hepatic carcinoma was more than that in pulmonary carcinoma(P=0.001). The prevalence of malnutrition in patients with anemia was higher than that without anemia. The prevalence of malnutrition in patients with infection was higher than that without infection. The higher the ECOG scale, the higher the prevalence of malnutrition. The results indicate that MNA is effective for diagnosis of malnutrition in oncological patients. The prevalence of malnutrition in gastric carcinoma or hepatic carcinoma patients was higher.