MNA-SF和GLIM标准在住院老年COPD患者营养评估中的应用

Applications of mini nutritional assessment short form and global leadership initiative on malnutrition criteria in nutritional assessment among elderly inpatients with chronic obstructive pulmonary disease

目的 比较微型营养评定(MNA-SF)和全球领导人营养不良倡议(GLIM)标准在住院老年慢性阻塞性肺疾病(COPD)患者营养不良诊断中的一致性。方法 采用方便抽样选取2020年1月至2021年12月于宜宾市第二人民医院住院老年COPD患者489例,采用MNA-SF和GLIM标准进行营养不良评估,并分析其结果的一致性。结果 采用MNA-SF诊断营养良好、营养不良风险和营养不良者分别为172例(35.17%)、228例(46.63%)和89例(18.20%),不同年龄段、是否合并慢性病及病程MNA-SF评分和营养不良情况差异有统计学意义(P<0.05)。通过营养风险筛查2002(NRS 2002)得到营养风险发生率为50.31%,GLIM标准诊断营养不良发生率为28.83%,<70岁患者营养风险和营养不良发生率高于≥70岁患者,合并慢性病患者营养风险和营养不良发生率高于未合并慢性病患者,病程越长营养风险和营养不良发生率越高(P<0.05)。MNA-SF和GLIM标准诊断营养不良的Kappa值为0.675,NRS 2002与MNA-SF诊断营养不良风险的Kappa值为0.619,将MNA-SF与GLIM诊断的营养不良等级进行相关性分析,其Kappa值为0.348(P<0.05)。结论 住院老年COPD患者营养风险和营养不良发生率高,MNA-SF和GLIM标准均可用于住院老年COPD患者营养不良诊断。

Objective To compare the consistency of mini nutritional assessment short form( MNA-SF) and global leadership initiative on malnutrition( GLIM) criteria in nutritional assessment among elderly inpatients with chronic obstructive pulmonary disease( COPD). Method From January 2020 to December 2021, 489 elderly COPD inpatients were randomly selected from the second peoples’ hospital of Yibin to assess the nutritional status by MNA-SF and GLIM criteria respectively, and to analyze the consistency of two methods. Result 172(35. 17%), 228(46. 63%) and 89(18. 20%) patients were diagnosed good nutrition, malnutrition risk and malnutrition by MNA-SF, respectively. There were significant differences in MNA-SF scores and malnutrition incidence among different age groups, whether combined chronic diseases, and course of disease(P<0. 05). The incidence of nutrition risk screening by nutritional risk screening 2002( NRS 2002) was 50. 31%, and the incidence of malnutrition diagnosed by GLIM was 28. 83%. The incidence of nutrition risk and malnutrition in <70 years old group was higher than that in ≥70 years old group. The incidence of nutrition risk and malnutrition in the group with chronic disease was higher than that in the group without chronic disease. The longer the course of disease, the higher the nutrition risk and malnutrition incidence(P<0. 05). The Kappa value of malnutrition diagnosed by MNA-SF and GLIM was 0. 675, and the Kappa value of nutrition risk diagnosed by NRS 2002 and MNA-SF was 0. 619, while the Kappa value of malnutrition severity level diagnosed by MNA-SF and GLIM was 0. 348(P<0. 05).Conclusion The nutritional risk and malnutrition rate are high among elderly COPD inpatients. MNA-SF and GLIM criteria can be used to diagnose malnutrition in elderly COPD inpatients.