握力测量在恶性肿瘤患者入院营养风险筛查中的应用价值研究

Study on application value of grip strength measurement in admission nutritional risk screening of patients with malignant tumor

目的探讨握力测量在恶性肿瘤患者入院时营养风险筛查中的应用价值。方法采用便利抽样法选取广西两家三级甲等医院肿瘤内科住院患者490例。收集握力及人体测量学指标,营养风险筛查2002(NRS-2002)进行营养风险筛查;采用Pearson相关分析握力及人体测量学指标与营养风险的相关性,logistic回归分析营养风险的预测指标;描绘受试者工作特征曲线(ROC曲线),计算预测营养风险的临界值。结果体重、体重指数(BMI)、小腿围、臂围、握力与患者营养风险状况呈负相关(P<0.01),而与年龄呈正相关(P<0.01)。握力是恶性肿瘤患者营养风险的预测因子。握力预测营养风险状况的ROC曲线下面积(AUC)>0.7(P<0.05),男性青年握力小于32.2 kg,男性老年小于26.9 kg,女性青年小于21.3 kg,女性老年小于20.5 kg可判断存在营养风险。结论握力测量简单、方便、快捷且经济,可作为恶性肿瘤患者入院时是否存在营养风险状况的筛查指标之一。

Objective To explore the application value of grip strength measurement in the admission nutritional risk screening of the patients with malignant tumors.Methods The convenience sampling method was used to select 490 inpatients from the oncology department of two class 3A hospitals in Guangxi for collecting the grip strength and anthropometric indicators.The nutrition risk screening was performed by the nutrition risk screening(NRS-2002).The Pearson correlation analysis was used to analyze the correlation between the grip strength and anthropometric indicators with the nutritional risk,the logistic regression was used to analyze the nutritional risk prediction indicators;the receiver operating characteristic(ROC)curve was drawn and the critical value of predicting nutrition risk was calculated.Results The nutritional risk status was negatively correlated with the body weight,body mass index,calf circumference,arm circumference and grip strength of the patients(P<0.01),while was positively correlated with the age(P<0.01);the grip strength was the predictive factor of nutritional risk in the patients with malignant tumors;the area under the ROC curve(AUC)for the grip strength in predicting the nutritional risk status>0.7(P<0.05),the grip strength of male youth<32.2 kg,the male elderly<26.9 kg,the female youth<21.3 kg and the female elderly<20.5 kg could judge the existence of nutritional risk.Conclusion The grip strength measurement is simple,convenient,fast and economical,and can serve as one of the screening indicators for predicting whether existing the nutritional risk status at admission in the patients with malignant tumors.