NRS2002、MNA和MNA-SF评价老年患者营养状况

目的 采用营养风险筛查(NRS2002)、微型营养评估表(MNA)、微型营养评定简表(MNA-SF)对某医院老年医学科新入院老年患者进行营养风险筛查,以明确老年患者营养风险现状和营养筛查工具的适用性,为基层医院临床营养筛查提供科学证据.方法 采用连续定点抽样方法,收集患者一般信息,使用NRS2002、MNA、MNA-S...     

简易营养评价法及简易营养评价精法对老年人营养不良的评价

目的将简易营养评价法(MNA)、简易营养评价精法(MNASF)及传统营养评价法进行比较。方法对144例住院老年患者同时应用MNA、MNASF及传统营养评价法进行调查,比较3种方法的异同。结果(1)MNA调查显示住院老年人营养不良患病率为361%,潜在营养不良为465%;MNASF对营养不良检出率为715%;传统方法的检出率在132%~722%之间;(2)MNA与传统营养评价法中的体质指数(BMI)、腓肠肌围、上臂肌围、三头肌皮褶厚度、白蛋白、前白蛋白、甘油三酯(TG)和血红蛋白(Hb)的相关系数在0204~0671之间(P<005);MNASF值与上述指标的相关系数在0233~0622之间(P<005);(3)MNA和MNASF相关系数为0933(P<005);与MNA相比,MNASF敏感性为857%,特异性960%,准确性875%。结论MNA和MNASF皆是老年人营养状况评价的可靠方法,MNA项目较详细,更适合于科研;MNASF简便,比较适用于临床。     

MNA-SF在老年高血压患者营养评价中的应用研究

目的探讨简易营养评价精法在老年高血压患者中运用的可行性。方法利用MNA-SF量表对老年高血压患者的营养状况做调查。结果 MNA-SF量表结果显示,营养不良者占11%,营养正常者占89%。结论 老年高血压患者仍存在营养不良的现象,应加强护理和健康教育。MNA-SF在老年高血压患者的营养评价中有一定的实用价值。     

老年性痴呆患者的营养状况研究

目的评估老年性痴呆(AD)患者的营养状况及其相关因素的关系。方法利用简易营养评价精法(MNASF)评价60例AD患者的营养状况,同时收集患者智能评分、生活自理能力以及相关的生化指标,以了解与营养不良发生有关的检查指标的相关性。结果AD营养不良的发生率为66.67%;AD组与正常对照组生化指标Hb、BUN、TP、Alb、WSCC比较时,差异有显著性意义(P<0.01);而两组年龄、SCr、TC结果比较无统计学差异(P>0.05);AD患者营养不良的发生与MMSE、ADL、Chol、TP、Alb、WSCC等检测指标有很高的相关性,与年龄、Hb、BUN、Scr等指标的相关性则不明显。结论AD患者营养不良的发病率高,AD患者的智力水平、日常生活自理能力是影响其自身营养状况的两个重要因素。     

老年卧床不起患者营养状况的调查

目的了解老年卧床不起患者的营养状况及其影响因素。方法利用简易营养评价法（MNA）调查卧床不起老年患者营养状况、影响因素和常见并发症。结果老年卧床不起患者营养不良患病率为60.0%,潜在营养不良占40.0%,无营养正常者。老年卧床不起患者营养不良的发生与年龄、病程、病因无关,主要与卧床不起的严重程度有关。老年卧床不起营养不良患者的褥疮、尿路感染、大便失禁、坠积性肺炎、废用性肌萎缩、尿失禁及关节挛缩的发生率明显高于非卧床不起营养不良患者（P〈0.05）。结论老年卧床不起患者营养不良患病率高且与卧床不起严重程度有关。     

MNA和NRS2002对老年住院患者营养评估的比较

目的简易营养评价法（MNA）是专为老年人设计的营养评估方法,而营养风险筛查2002（NRS2002）常用于住院患者,本研究探讨哪一种营养评估方法更适用于老年住院患者。方法本研究纳入了179名在内科老年病房住院的≥65岁的老年患者,分别应用MNA简表（MNA-SF）和NRS2002进行营养风险评估,比较两种筛查方法的评估结果以及对临床营养治疗的指导作用,并分析与传统的临床营养指标相关性。结果MNA-SF评估,营养不良危险者55例,营养不良者42例,总的营养风险异常率54．2％,较NRS2002筛查（有营养风险69例,38．5％）差异有统计学意义。MNA-SF筛查的营养不良危险组和营养不良组的营养治疗率分别为29．1％和50．0％,而NRS2002的营养风险组的营养治疗率为49．3％。常用的营养指标体质量指数（BMI）、体质量变化、血清白蛋白和前白蛋白与两种营养评估结果的相关性低（γ=0．09～0．48）,上述指标的异常对营养风险筛查结果无可靠的提示作用。结论内科住院老年患者的营养风险筛查,同一个患者群体MNA-SF可发现较多具有营养风险的患者,而NRS2002筛查结果异常对营养治疗的指导意义更大。常用的营养指标如BMI、血清蛋白不是可靠的营养风险筛查指标。     

使用微型营养评价精法评价中医科老年住院患者的营养状况

目的 使用微型营养评价精法(MNA-SF)评价中医科老年住院患者的营养状况,比较评估结果与人体测量、实验室检查指标之间的相关性.方法 以2012年4月至2012年7月在中日友好医院中医老年科、中医糖尿病科住院的139例老年患者(≥65岁)为研究对象.入院后第3天使用MNA-SF对研究对象进行评估.测量上臂围(AC)、小腿围(CC)、握力(GS),测量身高、体重,计算体质指数(BMI),记录入院后距进行评估最近的一次血清白蛋白(ALB)、血红蛋白(HB)检测值.结果 139例老年患者中存在营养不良风险59例(42.4％),营养不良24例(17.4％).评估结果与BMI、AC、CC、GS、ALB、HB之间呈正相关,r值分别为0.53、0.60、0.61、0.26、0.52、0.25,P＜0.01,P＜0.05.结论 中医科老年住院患者营养不良和营养不良风险发生率较高,营养状况随着年龄的增加、患病时间的延长而下降.MNA-SF是一种简单、有效、实用的评估方法,应在老年患者中推广使用,以便及时发现营养问题.     

应用MNA-SF和NRS2002评价老年结直肠癌患者营养状况

目的旨在通过运用营养风险筛查2002(NRS-2002)及微型营养评估精法(short-form mini-nutritional assessment,MNA-SF)工具对125例老年结直肠癌患者进行营养评估,并探讨NRS2002和MNA-SF与传统营养评价方法的相关性。 方法选定2012年3月至2013年9月哈尔滨医科大学附属第二医院普外科新入院结直肠癌患者125例作为研究对象。患者入院后48小时内采集营养相关指标,并应用NRS-2002和MNA-SF对患者进行营养评估,分析研究对象营养风险的总体情况,计算两种方法与传统指标的相关性。 结果125例结直肠癌患者应答率100%,无额外费用。用BMI中国标准判定营养不足发生率为30.0%,NRS2002营养风险率为32.8%,MNA-SF营养风险率为59.2%,NRS2002与BMI、Alb、Hb呈显著负相关系(P<0.05),MNA-SF与BMI、Alb、Hb呈显著正相关系(P<0.05)。 结论本组老年结直肠癌患者营养不良发生率较高,NRS2002和MNA-SF均适用于老年结直肠癌患者的营养评估,但尚未发现联合应用的额外获益。     

泰安市老年人营养状况的评价及改进的探讨

我们对本市190名老年人营养状况调查研究表明,本市老年人的营养状况基本达到营养学要求,但也存在热量和钠的摄入量高,而VB_2和钙摄入量低.农村老年人有VA摄入不足的不合理状况,有待今后膳食营养素进行合理搭配来解决。对头发中5种微量元素测定显示,29.1％的老年人缺锌,14.54％的老年人缺铁,因此也应对食物微量元素的摄入采取平衡膳食方法同,以保证老年人身体健康.     

老年人营养状况对生存质量影响的研究

目的：调查社区散居老人的营养和综合性生存质量现状,探讨营养状况对生存质量的影响。方法：采用二阶段随机抽样方法,入户调查120名（60－80岁）散居老人的营养状况（体质指数、膳食营养摄入、就餐习惯、就餐环境等）和生存质量（采用中华老年医学学会推荐的老年人生存质量和调查内容和评价标准）,结果：生存质量调查涉及的11项内容,评价为良的比例最低的是营养状况,评价为差的比例由高至低为生活满意度,营养状况和社会交往等。120名散居老人综合生存质量良、中、差的比较分别为25．0％、74．2％和0．8％。本组老人营养状况的高低与就餐环境（独居、两老单居、与小辈合居）密切相关,较为突出的营养问题是膳食能量,蛋白质和脂肪摄入过高的比例分别占总人数的25％、32％和53％,以致超重肥胖的比例高达41．7％,结论：老年人营养状况是影响其生存质量的重要因素之一,就餐环境对老年人营养状况的影响不容忽视。加强营养健康教育和膳食行为指导,保持良好的就餐习惯和氛围,有助于改善老年人的营养状况及生存质量。     

老年肺结核患者营养状况评价研究进展

结核病是一种慢性消耗性传染性疾病,与机体营养状况之间存在着双向的关系,相互影响。老年肺结核患者是一个特殊的群体,由于年龄大、抵抗力弱,常多病共存,其营养状况不理想,受多种因素影响。正确评价老年肺结核患者的营养状况是改善其营养摄入的基础。目前,全球针对老年肺结核患者营养状况评价指标的相关研究较多,且各不相同,但缺乏统一评价指标。笔者将国内外老年肺结核患者营养状况评价的相关研究进行综述,为临床进行老年肺结核患者的营养状况评价提供帮助和支持。     

简易营养评价精法及传统营养评价对老年稳定期慢性阻塞性肺病患者营养状态的评估

目的评估老年稳定期中、重度慢性阻塞性肺病（COPD）患者营养不良的发生率。了解简易营养评价精法（MNA—SF）和传统营养评价的相关性,为MNA—SF临床应用提供依据。方法测量52例老年稳定期中、重度COPD患者的体质指数（BMI）,理想体重比（IBW％）,三头肌皮皱厚度（TSF）,上臂肌围（MAMC）,血清白蛋白（ALB）,血色素（UB）,总淋巴细胞计数（TLC）,同时应用传统营养评价法和MNA-SF评估营养不良的发生率。结果营养不良的发生率：传统营养评价人体测量为30．8％-48．1％,实验室检查为19．2％～82．7％。MNA—SF营养不良的检出率为44．2％。MNA—SF与BMI、IBW％、TSF、MAMC有很好的相关性,P〈0．001。结论老年稳定期中、重度COPD患者营养不良发生率用传统营养测量评价为19．2％～82．7％。MNA-SF则为44．2％。MNA-SF是老年人营养评价的可靠方法,简便,适用于临床诊断。     

老年慢性阻塞性肺疾病营养状况与胰岛素水平的关系

目的　 研究老年慢性阻塞性肺疾病 (COPD)营养状况与胰岛素水平的关系 ,探讨COPD合并营养不良的机制。　 方法　对 38例老年COPD(分为营养不良组 18例 ,非营养不良组 2 0例 )急性发作期患者和 15例健康老年人 (对照组 )进行营养状况评价 ,同时测定其空腹血糖及胰岛素水平。　 结果 　COPD营养不良组、非营养不良组空腹血糖显著高于对照组 (P <0 0 5 )。营养不良组空腹胰岛素显著低于非营养不良组和对照组 (P <0 0 5 )。　 结论 　COPD营养不良的发生与胰岛素分泌不足有关。     

Evaluation of the nutritional status in older patients with aggressive haematological malignancies using the MNA-SF

BackgroundMalnutrition is common both after the age of 70 and in many types of cancer, being responsible for poor quality of life, poor treatment response and a shorter survival time. Patients with haematological malignancies face specific challenges regarding nutrition because of intensive treatments they endure. Early detection of nutritional problems is important to allow interventions.ObjectivesTo assess the nutritional status of a group of older patients with aggressive haematological malignancies before the onset of systemic therapy using the MNA-SF.SettingThe haematology department of a university hospital.ParticipantsPatients ≥ 70 years, with newly diagnosed aggressive haematological malignancies.MethodsObservational single centre study. Patients were screened for malnutrition before and two months after start of therapy using the Mini Nutritional Assessment Short Form (MNA-SF).ResultsSeventy patients were included. Mean age was 77.4 ± 4.7 years (range 70.0–91.0). At baseline, 20% (CI₉₅ = 11–31%) were malnourished and 61% (CI₉₅ = 49–73%) were at risk for malnutrition. Recent weight loss and declined food intake were the most recorded MNA-SF parameters. Mean Body Mass Index (BMI) was 26.3 ± 4.1 (range 19.8–41.1) and 41% (n = 29) of patients had a BMI < 25.ConclusionsUsing the MNA-SF, most of the older patients with an aggressive haematological malignancy are at risk for malnutrition. Therefore, nutritional assessment with individualised dietary advice and follow-up during treatment should be recommended as an integrated part of the treatment plan.     

Serum proteins and nutritional status of free-living Thai elderly

Fifty-six Thai males and 146 Thai females aged 60 years and above visiting a special clinic for the elderly were investigated. The serum protein and immunoglobulin of these elderly were assessed. Anthropometric measurements were also taken. From a random sample of the group, the dietary intake of main nutrients was determined by a 24 h recall method with the help of food models. Weight, height and mid-arm muscle circumference of males were greater than those of females. Triceps skinfold thickness was less in the males than in the females. Forty-seven per cent of the individuals investigated had ₁-antitrypsin levels below 200 mg/dl and 25.4% had IgG levels of 200 mg/dl and 39% IgA levels above 450 mg/dl. The males tend to consume more calories in the form of carbohydrates than the females. The nutritional density of fat was less than 20% in the males. A negative correlation between serum albumin and height and a positive correlation between serum IgG and tricep skinfold thickness were found. Weight was found to have a positive correlation with calories, carbohydrates and fat. Height correlated positively with calories, protein and carbohydrates. Serum prealbumin correlated with fat intake. It is concluded that, except for ₁-antitrypsin, IgA, serum proteins are found in a range normally detected also in elderlies in western countries. Body composition does not relate to level of protein intake.     

Prevalence of under-nutrition,associated factors and perceived nutritional status among elderly in a rural area of Puducherry,South India

BackgroundUnder-nutrition among elderly goes undetected, despite their nature of vulnerability to it. Majority of the available literature assessed under nutrition in the facility based settings. We aimed to determine the prevalence of under-nutrition and its associated factors among elderly, in a rural setting.MethodsA community based cross sectional survey was conducted among elderly in one of the randomly selected sub centre catchment area in rural Puducherry, south India. Information on socio demographic characteristics, morbidities and perception on their nutritional status were obtained. Anthropometric measures such as weight and arm span were measured by trained medical graduate as per the standard guidelines. Bodymass index (BMI) less than 18.5 kg/m² was considered as under-nutrition.ResultsOf total 296 elderly in the study setting, 271 (92%) participated in the study. The prevalence of under nutrition among the elderly was 24.8% (95% CI: 19.7–30.3). More than half of the elderly (58.7%) perceived their nutritional status as poor; of them 28.9% were actually under-nourished. Mean (SD) BMI scores were higher for elderly women compared to that of men [elderly women vs men: 22 (4.6) kg/m² vs 21 (3.8) kg/m², p = 0.03]. In multivariate analysis, being an elderly male, age more than 70 years and per capita income less than 1000 INR were found to be significantly associated with under-nutrition.ConclusionIn this rural area, one fourth of elderly were under nourished. Urgent inter-sectoral measures including food security programs are required to address this huge nutritional problem in this vulnerable group.