评价住院患者营养缺乏性营养不良敏感性指标的研究

Sensitive Markers for Evaluation of Malnourished Inpatients

目的探讨评价住院患者营养缺乏性营养不良的敏感指标。方法选取358例于2009年1月1日—2月1日在我院内科系统住院的患者,分析患者血浆总胆固醇水平、血浆清蛋白水平、血红蛋白水平、体质指数与营养状况的一致性,应用有序分类结局的Logistic回归方法选择在评价住院患者营养缺乏性营养不良时有意义的指标,并比较几项指标在评价中的敏感性。结果无论男性还是女性,不同营养状况组的血浆清蛋白、总胆固醇和血红蛋白水平间差异均有统计学意义(P<0.05)。对主观全面评定结果应用有序分类结局的Logistic回归分析显示:只有血浆清蛋白和血浆总胆固醇两项指标被引入模型,即这两项指标在评价住院患者营养缺乏性营养不良时才有意义,且血浆胆固醇水平较血浆清蛋白水平对预测营养不良更为敏感。结论低血浆总胆固醇水平是一个评价住院患者营养缺乏性营养不良的敏感指标,其预测价值优于低血浆清蛋白水平等传统指标。

Objective To investigate a sensitive evaluation marker for inpatients with nutritional deficiency malnutrition.Methods A total of 358 inpatients,who were treated in our hospital from January 1 to February 1,2009,were enrolled.The consistency of levels of serum cholesterol,albumin,hemoglobin,and body mass index（BMI） with nutritional status were analyzed.Ordinal Logistic regression analysis was used to choose significant index for malnourished inpatients.Results Irrespective of women or men,there were significant differences in levels of serum total cholesterol,albumin and hemoglobin among groups with different nutrition conditions with different nutrition conditions（P0.05）.For the result of subjective global assessment ordinal logistic regression showed that only the indexes of serum albumin and total cholesterol entered the model,or the two markers were significant in evaluation of malnourished inpatients,and total cholesterol was more sensitive than albumin.Conclusion Low serum total cholesterol concentration is a sensitive evaluation marker for malnourished inpatients,and it is more excellent than traditional parameters like serum albumin.