两种营养风险筛查工具在心血管内科老年住院患者中应用比较分析

目的探讨在心血管内科老年入院患者中合理选择营养风险筛查工具,以便及时实施营养干预,改善由于营养因素所导致的不良临床结局。方法测定200例入院老年患者体质指数（BMI）、血清清蛋白（ALB）、前清蛋白（PA）、血红蛋白（Hb）或淋巴细胞计数（LY）,作为营养指标进行营养不良评估。采用营养风险筛查（NRS2002）和营养风险指数（NRI）两种营养风险筛查工具,进行两种营养风险筛查工具评分相关性分析;营养风险发生情况比较分析;营养风险筛查评分与各营养指标相关性,以及各分值段营养指标水平比较。结果 BMI、ALB、PA、Hb和LY所显示营养不良发生率分别为：9.0%、2.8%、29.1%、20%和11%;NRS2002与NRI评分有负相关关系（P=0.0005）;NRS2002评分中轻微营养风险、中度营养风险和严重营养风险发生率分别为：52%、32.5%和5.5%,NRI评分分别为：13.5%、28.5%和1%。两种方法对于营养风险筛查结果不具有一致性（κ=0.115）,NRS2002对营养风险的检出率高于NRI。NRS2002评分与BMI、ALB、PA、Hb和LY具有负相关关系,NRI评分与ALB、PA、Hb和LY具有正相关关系;NRS2002和NRI评分各分值段间ALB、PA和Hb水平均有显著性差异,NRS2002评分各分值段间BMI也有显著性差异。结论 NRS2002整合了更多的与营养相关的指标,较之NRI,NRS2002对于心血管内科老年患者的营养风险的预测可能更好。

The Application of two kinds of nutritional risk screening in cardiovascular medical senile inpatients: a comparative analysis

Objective To prob into the rational choice of tools of nutritional risk screening so as to carry out nutritional intervention,improve bad clinical results due to nutritional factor.Methods The body mass index（BMI）,serum albumin（ALB）,prealbmin（PA） and hemoglobin（Hb） were assayed or lymphocytes（LY） counted malnutrition was assessed on these grounds in 200 senile inpatients.The results of the nutritional risk screening scoring were collelatively analyzed,the occurrences of nutritional risk comparativel analyzed and the correlation between the score of nutritional risk screening and all nutritive index and the nutritive index levels in all score value sections compared by inpatient Nutritional Risk Screening 2002（NRS2002） and Nutritional Risk Index（NRI）.Results The incidence rates of malnutrition showed by BMI,ALB,PA,Hb and LY were 9.0%,2.8%,29.1%,20% and 11%,respectively.There was a negative corrlation between the score of NRS2002 and the score of NRI（P=0.0005）.The incidence rates of mild,moderate and severe nutritional risk in the NRS2002 scoring were 52%,32.5% and 5.5%,respectively but those in the NRI scoring 13.5%,28.5% and 1%,respectively.The results of the nutritional risk screening showed lacked uniformity between both methods（κ=0.115）.The detectale rate of nutritional risk of NRS2002 was higher than that of NRI.There were a negative correlation between the score of NRS2002 and BMI,ALB,PA,Hb and LY and a positive correlation between the score of NRI and ALB,PA,Hb and LY.There was a significant difference between the ALB,PA and Hb levels in all score value sections in the NRS2002 and NRI scoring and also a significant difference between the BMI in all score value sections in the NRS2002 scoring.Conclusion NRS2002 integrates more indexes related to nutrition and may be better for the prediction of nutritional risk in cardiovascular medical senile patientes compared with NRI.