三种主观评价量表对中老年脑卒中住院病人营养评估效果的比较

Comparison of three different subjective assessment tools for nutritional assessment and screening at middle and aged patients with stroke

目的:比较营养风险筛查2002(NRS 2002)、微型营养评价精法(MNA-SF)和整体营养状况主观评估(PG-SGA)对评估中老年脑卒中病人营养状况的效果。方法:选取116例中老年脑卒中病人,采用NRS 2002、MNA-SF、PG-SGA和体格检查、生化检查结果评价营养状况以及营养不良的诊断和分级。结果:NRS 2002、MNASF、PG-SGA的营养不良评估结果均与体格检查和生化测定结果显著相关(P<0.05)。筛选营养不良病人时,NRS 2002具有较高的灵敏度(95.7%)和特异性(50.0%),约登指数为45.7%,高于MNA-SF和PG-SGA;筛选中、重度营养不良病人时,MNA-SF具有较高的特异性(73.5%),约登指数为55.2%,高于NRS 2002和PG-SGA。结论:对中老年脑卒中的住院病人,NRS 2002可更有效地筛选营养不良,MNA-SF可更有效地精选中、重度营养不良。

Objective： To evaluate the clinical usefulness of the subjective assessments of nutritional status, including Nutrition Risk Screening 2002 （ NRS 2002） , Short Form Mini Nutrition （ MNASF） and Patient-Generated Subjective Global Assessment （PG-SGA）. Methods ： 116 stroke patients were rolled in our study. The objective factors and NRS 2002, MNA-SF, PG-SGA were evaluated. Results： NRS 2002, MNA-SF, PG-SGA indicated meaningful correlation with the objective malnutrition （P 〈 0. 05 ）. When grouped into nutritionally normal and abnormally groups, Youden coefficients （45.7%） of NRS 2002 was higher, the sensitivity and specificity were 95.7% and 50.0%. Re-categorizing into two new groups by combining normal nourished and mildly nourished, Youden coefficients （55.2%） of MNA-SF was higher, and sensitivities and speeifieities were 81.7%0 and 73.5%. Conclusion ： It is proposed that the NRS 2002 would be more useful in screening malnourished while MNA-SF would be more useful in screening moderately and severely malnourished.