主观综合性评估乙型肝炎性肝硬化病人的营养状况

Application of subjective global nutritional assessment in patients with hepatitis-B-related liver cirrhosis

目的:探讨主观综合性营养评估(SGA)在乙型肝炎性肝硬化病人中的应用价值。方法:回顾分析乙型肝炎性肝硬化病人140例,根据Child-Pugh分级,将病人分为A、B和C组,比较各组间营养指标的差异,并分析Child-Pugh分级与营养指标的相关性。结果:乙型肝炎性肝硬化病人营养不良的总发生率为42.85%,其中轻-中度营养不良40例(28.57%),重度营养不良20例(14.29%)。各组间的体重指数(BMI)、肱三头肌皮皱厚度(TSF)、上臂围(AC)、上臂肌围(AMC)、肌酐身高指数(CHI)、血清转铁蛋白(TF)和清蛋白(ALB)等差异均有显著性统计学意义(P<0.05)。BMI和血清TF与病人Child-Pugh分级相关性不显著(P>0.05),而AMC、TSF、CHI和血清ALB与病人Child-Pugh分级均呈负相关(r分别为-0.404、-0.673、-0.597、-0.814,P<0.05)。结论:肝硬化病人多存在不同程度的营养不良,SGA可用于肝硬化病人营养状况的评估。

Objective ： To explore the application value of subjective global nutritional assessment （SGA） in patients with hepatitis-B-related liver cirrhosis. Methods： 140 cases of hepatitis B cirrhosis were retrospectively reviewed. According to the Child-Pugh classification, the patients were divided into three groups. The differences of the nutritional indexes and the correlations of Child-Pugh classification and nutritional indexes were recorded. Results ： The incidence of malnutrition in patients with hepatitis B cirrhosis was 42.85% , with mild to moderate malnutrition in 40 cases （28.57%） and in severe malnutrition 20 cases （ 14.29% ）. The differences of BMI, TSF, AMC, CHI and TF were statistically significant （P 〈 0.05 ） between groups. The Child-Pugh classification had obviously negative correlations with AC, AMC, CHI and Alb. However,the Child-Pugh classification had no correlations with BMI and TSF. Conclusion ： Patients with liver cirrhosis have different degrees of malnutrition. SGA can be used in evaluation of nutritional status of patients with cirrhosis.