三种营养筛查工具对食管癌患者营养不良的评价比较

Evaluation and Comparison of Three Nutrition Screening Tools for Malnutrition in Esophageal Cancer Patients

目的:探讨三种营养筛查工具在食管癌患者营养不良评价中的应用价值。方法:选取2019年2月至2019年8月在某三甲专科医院住院的287例食管癌患者,采用营养风险筛查2002(Nutritional Risk Screening 2002,NRS2002)、患者提供的主观整体营养状况评估量表(Patient-Generated Subjective Global Assessment,PG-SGA)和预后营养指数(Prognostic Nutritional Index,PNI)评估患者营养不良风险,分析三种营养筛查工具与各营养指标的相关性,并以营养不良评定(诊断)标准共识(Global Leadership Initiative on Malnutrition,GLIM)为金标准,比较三种营养筛查工具的诊断效能。结果:三种营养筛查工具与人体成分和血生化指标均存在相关关系(P<0.05),PNI与各营养指标的复合相关系数最大(r=0.692,P<0.001)。诊断效能评价中,PG-SGA的灵敏度和正确指数最高,分别为85.70%和54.00%;NRS2002特异性最高,为71.30%。结论:三种营养筛查工具均能为诊断食管癌患者营养不良提供依据,在临床中联合应用更能全面反映患者营养状况。

Objective:To clarify the applicability of three nutritional screening tools in the assessment of malnutrition in esophageal cancer patients.Methods:Nutritional Risk Screening 2002(NRS 2002),Patient-Generated Subjective Global Assessment(PG-SGA)and Prognostic Nutritional Index(PNI)were used for screening and evaluation of malnutrition in 287 patients with esophageal cancer.Correlation between three nutrition screening tools and nutrition indicators was analyzed.With Global Leadership Initiative on Malnutrition as the gold standard,the diagnostic efficacy of the three nutrition screening tools were compared.Results:All three nutrition screening tools were significantly correlated with anthropometric and blood biochemical indicators(P<0.05),and the multi-correlation coefficient of r for the correlation between PNI and nutrition indicators was the largest(r=0.692,P<0.001).In the evaluation of diagnostic efficacy,sensitivity and correctness index of PG-SGA were the highest(85.7%and 54%);and the specificity(71.3%)of NRS2002 was the highest.Conclusion:All three nutrition screening tools can provide a basis for diagnosing mainutrition in patients with esophageal cancer.The combined application can better reflect the nutritional status of patients in the clinic.