微型营养评价法与主观全面评价法的比较

Comparison of mini-nutrition assessment and subjective global assessment

目的探讨评估老年恶性肿瘤患者营养状态:微型营养评价法(mini-nutritional assessment,MNA)及主观全面评价法(subjective global assessment,SGA)对老年恶性肿瘤患者营养状态的评价作用,并比较MNA和SGA。方法对102例老年恶性肿瘤患者进行MNA、SGA评价和传统营养评价指标测量。结果(1)根据MNA评价结果,营养正常者、潜在营养不良者、营养不良者分别为27.4%、35.3%、37.3%;根据SGA评价结果,营养正常者、轻中度营养不良者、重度营养不良者分别为43.1%、21.6%、35.3%。(2)根据MNA评价,营养正常组、潜在营养不良组和营养不良组的体质量指数(body mass index,BMI)、肱三头肌皮褶厚度(triceps skin-fold thickness,TSF)、上臂肌围(arm muscle circumference,ACMC)、腓肠肌围(calf circumference,CC)、血红蛋白(hemoglobin,Hb)、总蛋白(totalprotein,TP)、白蛋白(albumin,Alb)、前白蛋白(prealbumin,PA)、总淋巴细胞计数(total lymphocyte count,TLC)等指标,3组之间相互比较差异有显著性,(P<0.05)。根据SGA评价,营养正常组和轻中度、重度营养不良组比较,其BMI、ACMC、CC、Hb、TP、Alb、PA、TLC等指标差异有显著性(P<0.05)。轻中度营养不良组和重度营养不良组比较,其TP、Alb差异有显著性,(P<0.05)。结论(1)恶性肿瘤患者营养不良的发生率高;(2)MNA和SGA皆是评价老年恶性肿瘤患者营养状态的简单有效方法,在评价老年恶性肿瘤营养状态与传统营养评价指标上总体趋势一致,在某些方面,MNA优于SGA。

Objective To compare the nutritional status evaluated by mini-nutrition assessment （MNA） and subjective global assessment （SGA） in elderly patients with malignant tumor. Methods MNA, SGA and the classical nutritional assessment were carried our to assess the nutritional status of 102 elderly malignant tumor patients. Results （1） By MNA, the prevalence of normal nutritional status, malnutrition at risk and malnutrition were 27. 4%, 35. 3% and 37. 3% respectively, while by SGA, the prevalence of normal nutritional status, mild-to-moderate malnutrition and severe malnutrition were 43.1%, 21.6% and 35.3% respectively. （2） By MNA, some parameters such as body mass index （BMI）, triceps skin-fold thickness （TSF）, ann muscle circumference （AMC）, calf circumference （CC）, hemoglobin （Hb）, total protein （TP）, albumin （Alb）, prealbumin （PA）, and total lymphocyte count （TLC） were different among the normal nutritional status group, malnutrition at risk group and malnutrition group （ P 〈 0.05 ）. By SGA, the BMI, AMC, CC, Hb, TP, Alb, PA and TLC were different between the normal nutritional status group and mild-to-moderate malnutrition and severe malnutrition groups （ P 〈 0.05 ）, while only TP and Alb were different between the mild-to-moderate malnutrition group and severe malnutrition group （P 〈 0. 05 ）. Conclusion （ 1 ） There is a high prevalence of malnutrition in elderly malignant tumor patients. （2） MNA and SGA are simple and effective for evaluating the nutrition status in elderly malignant tumor patients, both methods maintain consistency with classical nutritional assessment in evaluating elderly malignant tumor patients, and MNA is however better than SGA to some extent.