GNRI与NRS2002在糖尿病肾病患者中应用价值的探讨

The Explore of Application Value between GNRI and NRS2002 in Patients with Diabetic Kidney Disease

目的比较老年营养风险指数(GNRI)与营养风险筛查2002(NRS2002)在糖尿病肾病(DKD)患者中的应用价值。方法选取DKD患者218例,采用GNRI及NRS2002分别对其进行营养风险筛查。收集患者相关营养及肾功能指标,对两种筛查工具评分与上述生化指标进行相关性分析。结果218例患者中GNRI评分<92分的有91例(41.7%),NRS2002评分≥3分的有51例(23.4%),二者营养风险筛查结果的一致性不理想。两种筛查工具得分与营养指标体质指数(BMI)、血清白蛋白(Alb)、血清前白蛋白(PA)、血红蛋白(HGB)均具有相关性(P<0.01)。GNRI得分与肾功能指标(尿微量白蛋白/尿肌酐)ACR、肾小球滤过虑(eGFR)、随机尿蛋白/随机尿肌酐(Up/Ucr)、24 h尿蛋白(24 h UP)、肌酐(Cr)、尿素(BUN)具有相关性(P<0.01),NRS2002得分与肾功能指标无相关性(P>0.05)。结论相比NRS2002,GNRI能更好地反映DKD患者营养及肾功能状况,适宜在临床推广应用,为DKD患者的精准营养支持提供科学依据。

Objective To explore the application value of GNRI and NRS2002 in patients with diabetic kidney disease.Methods A total of 218 cases were enrolled.The GNRI and NRS2002 was adopted to assess nutritional risk,and patients’nutritional or renal function indexes were also collected.The Spearman was used to analysis the relationship between the two scales’scores and chemical indicators above.Results The rates of nutritional risk assessed by GNRI and NRS was 41.7%(91 cases)and 23.4%(51 cases)respectively.The Kappa coefficient value was 0.316 between the two scales(P<0.01).The correlation between GNRI or NRS2002 and the nutritional indexes(BMI,Alb,PA,HGB)were significant.The correlation between GNRI and the renal function indexes(ACR,eGFR,Up/Ucr,24h UP,Cr,BUN)were significant(P<0.01),but the results of NRS2002 was negative(P>0.05).Conclusion Compared to NRS2002,GNRI can better reflect the patients’nutritional status and renal function.So it worth popularizing in clinical that will provide a theoretical basis for nutritional support in patients with diabetic kidney disease.