应用MNA和NRS2002评价老年胰腺癌患者营养状况

Assessment of the Nutritional Status of the Elderly Patients With Pancreatic Cancer by MNA and NRS2002

目的旨在通过运用营养风险筛查2002(NRS2002)及微型营养评估(mini-nutritional assessment,MNA)工具对30例老年胰腺癌患者进行营养评估,进一步指导围手术期营养支持,并探讨NRS2002和MNA与传统营养评价方法的相关性。方法选取2014年12月—2018年12月黑龙江省医院新入院胰腺癌患者(年龄≥65岁)30例作为研究对象。患者入院后48小时内,采集营养相关指标,并应用NRS-2002和MNA对患者进行营养评估,分析研究对象营养风险的总体情况,计算两种方法与传统指标的相关性。结果 30例胰腺癌患者的应答率为100%,无额外费用。用BMI中国标准判定营养不足发生率30.0%,NRS2002营养风险率56.7%,MNA营养风险率63.3%,NRS2002与Alb、Hb、BMI呈显著负相关(P <0.05),MNA与Alb、Hb、BMI呈显著正相关(P <0.05)。结论 (1)本组老年胰腺癌患者营养不良发生率仍较高,NRS2002和MNA均适用于老年胰腺癌患者的营养评估,但尚未发现联合应用的额外获益。(2)MNA和NRS2002均来源于欧洲,仍需进一步本土化验证,或构建适合亚洲人种特点及适合不同疾病特点的营养评估体系。

Objective To assess the nutritional status in elderly patients with pancreatic cancer, and to analyze the correlation between different tools, and to confirm the correlation of mini-nutritional assessment (MNA) and NRS2002 with classical nutritional markers. Methods 30 newly admitted pancreatic cancer patients (aged over 65 years) from December 2014 to December 2018 in Heilongjiang Hospital were selected as the study subjects. Nutrition-related indicators were collected within 48 hours after admission. Nutrition assessment was conducted with NRS2002 and MNA. The overall situation of nutritional risk was analyzed. The correlation between the two methods and traditional indicators was calculated. Results The response rate of 30 patients with pancreatic cancer was 100% without additional cost. The incidence of undernutrition was 30.0% according to BMI Chinese standard. The nutritional risk rate of NRS 2002 was 56.7%. The nutritional risk rate of MNA was 63.3%. NRS2002 was negatively correlated with Alb, Hb and BMI (P < 0.05). MNA was positively correlated with Alb, Hb and BMI (P < 0.05). Conclusion (1) The incidence of malnutrition in elderly patients with pancreatic cancer is still high. Both NRS2002 and MNA are suitable for nutritional assessment of elderly patients with pancreatic cancer, but no additional benefit has been found.(2) MNA and NRS2002 are both from Europe, and need to be further localized to validate, or to construct a nutritional assessment system suitable for Asian race characteristics and different disease characteristics.