NUTRIC评分与NRS 2002在ICU老年脑卒中病人营养风险评估中的效果比较

Comparison of NUTRIC Score and NRS 2002 in nutritional risk assessment of elderly stroke patients in ICU

目的:比较危重症营养评分(NUTRIC)与营养风险筛查量表2002(NRS 2002)对神经内科重症监护室(ICU)老年脑卒中病人营养风险及并发症的预后效果。方法:选取2020年4月—2021年4月于河南省人民医院神经内科ICU住院的80例老年脑卒中病人为研究对象,评估病人入住ICU时的NRS 2002和NUTRIC评分,测量病人入住和转出ICU时的体质指数(BMI)、肱三头肌皮褶厚度(TSF)、上臂中段围(MAC)、血清清蛋白(ALB)、前清蛋白(PA)及血红蛋白(Hb)水平。根据病人ICU转出时的营养状况及并发症情况将病人分为营养不良组(n=31)与营养正常组(n=49)、并发症组(n=24)和无并发症组(n=56),比较两组NRS 2002和NUTRIC评分的差异,采用受试者工作特征(ROC)曲线分析NRS 2002和NUTRIC评分对病人营养风险的诊断价值。结果:营养不良组入院时NUTRIC与NRS 2002评分均低于营养正常组(P<0.05);NRS 2002评分与BMI、ALB、PA、TSF呈负相关,NUTRIC评分与BMI、ALB、PA、TSF、MAC及Hb呈负相关(P<0.05);NUTRIC评分定性预测营养不良的敏感度(96.77%)和特异度(73.47%)均高于NRS 2002评分(87.10%、36.73%);NUTRIC定量预测营养不良的ROC曲线下面积(0.894)高于NRS 2002评分(0.759)。并发症组NUTRIC评分高于无并发症组(P<0.05),两组NRS 2002评分差异无统计学意义(P>0.05)。结论:NUTRIC评分对神经内科ICU老年脑卒中病人营养风险及并发症风险的预测性能相对优于NRS 2002量表。

Objective:To compare the prognosis of nutritional risk and complications of elderly stroke patients in the neurological intensive care unit(ICU)with NUTRIC Score and NRS 2002.Methods:80 elderly stroke patients who were hospitalized in the ICU of the department of neurology of Henan Provincial People's Hospital from April 2020 to April 2021 were selected as the study subjects.The NRS 2002 and NUTRIC scores of the patients at the time of admission to the ICU were evaluated,and the body mass index(BMI),triceps skinfold thickness(TSF),mid⁃arm circumference(MAC),serum albumin(ALB),prealbumin(PA)and hemoglobin(Hb)levels of the patients at the time of admission and transfer from the ICU were measured.The patients were divided into malnutrition group(n=31),normal nutrition group(n=49),complication group(n=24)and uncomplicated group(n=56)according to their nutritional status and complications at the time of ICU transfer.NRS 2002 and NUTRIC scores were compared between different groups.ROC curve was used to analyze the diagnostic value of NRS 2002 and NUTRIC scores for nutritional risk.Results:NUTRIC and NRS 2002 scores in malnutrition group were significantly lower than those in normal nutrition group(P<0.05);NRS2002 score was negatively correlated with BMI,ALB,PA and TSF,while NUTRIC score was negatively correlated with BMI,ALB,PA,TSF,MAC,and Hb(P<0.05);NUTRIC score had higher sensitivity(96.77%)and specificity(73.47%)in qualitative prediction of malnutrition than NRS 2002 score(87.10%,36.73%,respectively);The area under the ROC curve of NUTRIC quantitatively predicting malnutrition(0.894)was higher than NRS 2002(0.759).NUTRIC score in complication group was higher than that in non⁃complication group(P<0.05),but NRS 2002 score had no statistical difference(P>0.05).Conclusion:NUTRIC score was better than NRS 2002 scale in predicting nutritional risk and complication risk in elderly stroke patients in ICU of neurology department.