SGA、MNA和NRS2002评估失代偿期肝硬化患者营养状态应用价值分析*

目的 研究主观全面评定法(SGA)、简易营养评价法(MNA)和营养风险筛查2002(NRS2002)用于失代偿期肝硬化患者营养评估的应用价值。方法 2017年1月～2018年1月我院收治的98例失代偿期肝硬化患者,采用SGA法、MNA法和NRS2002法行营养风险筛查。采用Kappa一致性检验评估SGA、MNA和NRS2002对患者营养不良评价的一致性。结果 MNA法判定患者轻中度营养不良发生率为36.7%,重度营养不良发生率为30.6%,SGA法判定患者轻中度营养不良发生率为30.6%,重度营养不良发生率为2.0%,NRS2002法判定患者轻中度营养不良发生率为25.5%,重度营养不良发生率为15.3%;SGA法与MNA法评定结果一致性检验的Kappa值为0.344,差异显著(P＜0.05),SGA法与NRS2002法评定结果一致性检验的Kappa值为0.476,存在显著性差异(P＜0.05),MNA法与NRS2002法评定结果一致性检验的Kappa值为0.463,也差异显著(P＜0.05)。结论 现行的营养评估方法在评估失代偿期肝硬化患者营养状况时,可能存在显著性差异,还需要针对这类人群设计合理、可行的方法评估,以正确地指导临床治疗。

Application of SGA,MNA and NRS2002 in nutritional assessment of patients withdecompensated liver cirrhosis

Objective Objective The purpose of this study was to investigate the application of subjective comprehensive assessment(SGA),simple nutritional assessment(MNA)and nutritional risk screening 2002(NRS2002)in nutritional assessment of patients with decompensated cirrhosis.Methods 98 patients with decompensated liver cirrhosis were admitted to our hospital between January 2017 and January 2018,and the nutritional risk were screened by SGA,MNA and NRS2002 in all the patients.The consistency of the three methods was compared byKappa value.Results The incidence of mild to moderatemalnutrition by MNA was 36.7%and that of severe malnutrition was 30.6%,the incidence of mild to moderate malnutrition by SGA was 30.6%and that of severe malnutrition 2.0%,and the incidence of mild to moderate malnutrition by NRS2002 was 25.5%and that of severe malnutrition was 15.3%;the Kappa value was 0.344(P<0.05)as regard to the consistence of SGA and MNA,the Kappa valve was 0.476(P<0.05)as regard to the consistence of SGA and NRS2002,and the Kappa value was 0.463(P<0.05)as the consistence of evaluation by MNA and NRS2002 were compared.Conclusion The differences of malnutrition status assessed by different methods in our series might be great,which hints further investigation needed in the future for objective evaluation in this setting.