NRS 2002和PG-SGA在恶性肿瘤同步放化疗患者中的应用比较

Comparison of NRS 2002 and PG-SGA in Patients with Malignant Tumors Undergoing Concurrent Chemoradiotherapy

目的:比较营养风险筛查2002(Nutrition risk screening 2002,NRS 2002)和患者参与主观整体评估量表(Patient generated-subjective global assessment,PG-SGA)在恶性肿瘤同步放化疗患者中应用差异,为临床提供更优方案。方法:采用方便抽样,选以恶性肿瘤同步放化疗患者,同时应用两者评估营养状况,并比较。结果:NRS 2002评定57例患者(38.0%)存在营养风险,PG-SGA评定105例(70.0%)存在营养不良。秩和检验分别比较两者各条目得分,得分主要来源于营养状态和疾病代谢相关因素(P<0.001)。以PG-SGA评定营养不良(≥4分)为标准,NRS 2002 Kappa值=0.37(P<0.001)。以PG-SGA评定重度营养不良(≥9分)为标准,NRS 2002 Kappa值=0.59(P<0.001)。两者分组结果χ^2检验显示差异来自非重度营养不良/风险组(PG-SGA:<9分,NRS 2002:<3分)(P<0.001)。以PG-SGA评定营养不良(≥4分)或NRS 2002筛查存在营养风险(≥3分)患者为标准,NRS 2002 ROC曲线下面积0.873(95%CI:0.817~0.928)(P<0.001);PG-SGA 0.995(95%CI:0.986~1.00)(P<0.001)。结论:PG-SGA评定阳性率比NRS 2002高,两者评定差异来自非重度营养/风险组。临床上应以阻止或减缓下降甚至增加患者体重为目标来制定营养干预措施。医护人员应按要求定期使用NRS 2002筛查患者营养状况,结果阳性则使用PG-SGA评定,及时进行营养干预。

Objective:To compare the application of nutrition risk screening 2002(NRS 2002)and patient-generated subjective global assessment(PG-SGA)in patients undergoing concurrent chemoradiotherapy for malignant tumors.Provide better solutions for clinical.Methods:Using convenient sampling,patients with malignant tumors undergoing concurrent chemoradiation were selected,and both were used to assess the nutritional status and compare.Results:NRS 2002 assessed 57 patients(38.0%)as having nutritional risk,and PG-SGA evaluated 105 patients(70.0%)as having malnutrition.The rank sum test compares the scores of the two items,and the scores are mainly derived from factors related to nutritional status and disease metabolism(P<0.001).Based on PG-SGA assessment of severe malnutrition(≥4)as the standard,the NRS 2002 Kappa value=0.37(P<0.001).Based on PG-SGA assessment of severe malnutrition(≥9)as the standard,the NRS 2002 Kappa value=0.59(P<0.001).Theχ^2 test of the grouping results showed that the difference was from the non-severe malnutrition/risk group(PG-SGA:<9;NRS 2002:<3)(P<0.001).Based on PG-SGA assessment of patients with malnutrition(≥4 points)or NRS 2002 screening for patients with nutritional risk(≥3 points)as the standard,the area under the ROC curve was NRS 20020.873(95%CI:0.817~0.928)(P<0.001);PG-SGA 0.995(95%CI:0.986~1.00)(P<0.001).Conclusion:The positive rate of PG-SGA is higher than that of NRS 2002.The difference between the two ratings comes from the non-severe nutrition/risk group.Clinically,nutrition interventions should be developed with the goal of preventing or slowing down or even increasing patient weight.Medical staff should regularly use NRS 2002 to screen the nutritional status of patients as required.Positive results should be assessed using PG-SGA for timely nutrition intervention.