营养风险筛查在评估肥胖伴糖尿病患者中的应用

Application of nutritional risk screening assessment in patients with obesity complicated by diabetes mellitus

目的探讨营养风险筛查在评估肥胖伴糖尿病患者营养风险时的应用价值。方法选取2016年7月至2018年6月因糖尿病来内分泌科住院治疗的肥胖伴糖尿病患者154例,根据入院时间顺序随机分为对照组78例和观察组76例,其中对照组应用简易营养评价法(MNA)对患者营养状况进行评价,观察组应用营养风险筛查2002(NRS2002)对患者营养状况进行评价,分析和比较两种营养评估方法的效果。监测所有入组患者的营养生化指标(ALB、PA、SCR、BMI),分析NRS2002和MNA与营养生化指标的相关性;比较NRS2002<3分和≥3分人群营养生化指标的差异,MNA<23.5和≥23.5人群营养生化指标差异。结果154例患者均通过了MNA和NRS2002筛查,两种调查方法在本次调查中的适用性极好,适用率达到100%。MNA和NRS2002营养风险评价结果差异无统计学意义(P<0.05)。NRS2002<3分和≥3分人群营养生化指标比较,ALB、PA、SCr均差异有统计学意义(P<0.05),而BMI比较差异无统计学意义(P>0.05);MNA与NRS2002结果一致。NRS2002和MNA均与ALB、PA、SCR、BMI有一定的相关性,结果有统计学意义(P<0.05)。结论NRS2002和MNA在肥胖伴糖尿病患者中均具有较高的应用价值,而前者操作简便易行,更容易被医护及患者所接受,值得临床推广。

Objective To investigate the application value of nutritional risk screening assessment in patients with obesity complicated by diabetes mellitus.Methods A total of 154 patients with obesity complicated by diabetes mellitus who were treated in our hospital from July 2016 to June 2018 were enrolled in the study,who were divided into control group(n=77)and observation group(n=76)according to the admission time.The nutritional status of patients in control group was evaluated by simple nutrition evaluation(MNA),however,which in observation group was evaluated by nutrition risk screening(NRS2002).The effects of the two nutritional assessment methods,and the nutritional biochemical parameters(ALB,PA,SCR,BMI)were observed and compared between the two groups.Results A total of 154 patients underwent MNA and NRS2002 screening,and both survey methods had excellent applicability,with the application rate being 100%.There were no significant differences in nutritional risk assessment results between MNA and NRS2002(P<0.05).There were significant differences in nutritional biochemical indexes including ALB,PA and SCr between the patients with NRS2002<3 points and the patients with NRS2002≥3 points(P<0.05),but there was no significant difference in BMI between the two groups(P>0.05).Moreover the results of MNA and NRS2002 were consistent,and NRS2002 and MNA were closely correlated with ALB,PA,SCR and BMI(P<0.05).Conclusion NRS2002 and MNA are of higher application value in nutritional risk screening assessment for patients with obesity complicated by diabetes mellitus,moreover,the former is easy to be operated and more easily accepted by medical staff and patients,therefor,which is worthy of clinical promotion.