基于RFH-NPT联合RFH-GA筛查与评估失代偿期肝硬化患者的营养风险状况及相关因素分析

Analysis of Nutritional Risk,Nutritional Status and Related Factors of Patients with Decompensated Liver Cirrhosis Based on Screening of R FH-NPT Combined with Evaluation of RFH-GA

目的基于英国皇家自由医院营养优先工具(RFH-NPT)及英国皇家自由医院营养全面评定法(RFH-GA)筛查与评估失代偿期肝硬化患者的营养风险及营养不良程度,了解影响营养风险及营养不良程度的相关因素,分析营养不良程度与预后的关系。方法采用RFH-NPT及RFH-GA对100例失代偿期肝硬化患者进行营养筛查及评估,分析其结果与患者体格检查指标和实验室指标的相关性;并随访24个月,研究营养不良程度与并发症发生率、病死率的关系,探究影响患者生存时间的相关因素。结果94%患者存在营养风险(RFH-NPT≥1分),不同年龄组和不同Child-Pugh分级患者营养风险发生率有统计学差异(P<0.05);RFH-NPT营养风险筛查结果与三头肌皮褶厚度(TSF)、上臂肌围(AMC)、前白蛋白(PA)、白蛋白(ALB)存在相关性(均P<0.05)。中度及重度营养不良患者分别占比60%、19%,不同Child-Pugh分级患者营养不良程度有统计学差异(均P<0.05);营养不良程度与身体质量指数(BMI)、TSF、AMC、PA、ALB存在相关性(均P<0.05);不同营养状态其并发症的发生率及死亡率有统计学差异(均P<0.05);年龄、Child-Pugh分级、营养状态对生存时间的影响具有统计学意义(均P<0.05)。结论随着年龄的增加及Child-Pugh分级的增加,失代偿期肝硬化患者营养风险发生率随之升高;失代偿期肝硬化患者营养不良程度越重,其并发症发生率及病死率越高。RFH-GA分级是影响生存时间的独立影响因素。

Objective To screen and assess the nutritional risk and degree of malnutrition in pa tients with decompensated cirrhosis based on the the Royal Free Hospital Nutrition Prioritisation Tool(RFH-NPT)and the Royal Free Hospital Global As-sessment of Nutrition(RFH-GA),to understand the factors that influence nutritional risk and degree of malnutrition,and to an-alyze the relationship between the deg ree of malnutrition and prognosis.Methods The RFH-NPT and RFH-GA were used to screen and assess the nutritional risk of 100 patients with decompensated liver cirrhosis,and to analyze the correlation between the results and the patient's physical examination and between the results and laboratory indices.The patients were followed up for 24 months to study the relationship between the degree of malnutrition and the incidence of comp lications,morbidity and mortality,and to explore the related factors that influence survival time.Results The incidence of nutritional risk(the score of RFH-NPT≥1)was 94%in 100 patients with decompensated liver cirrhosis.Statistically significant differences were found in the prevalence of nutritional risk in patients of different age groups and different Child-Pugh classifications(P<0.05).The rele-vance was also found between RFH-NPT score and Triceps skinfold thickness(TSF),Arm muscle circumference(AMC),and Prealbumin(PA),Albumin(ALB)(all P<0.05).The proportion of patients with moderate and severe malnutrition was 60%and 19%respectively,and there was a statistical difference in the degree of malnutrition between patients with different Child-Pugh classifications.The relevance was found between RFH-GA score and BMI(body mass index),TSF,AMC,PT,ALB.Statistically significant differences was found in the incidence of complications and mortality by different nutritional status(all P<0.05).Age,Child-Pugh classification and nutritional status has a statistically significant effect on survival time(all P<0.05).Conclusion The incidence of nutritional risk in patients with decompensated cirrhosis increased with increasing age and Child-Pugh classification.The greater the degree of mal nutrition of patients with decompensated liver cirrhosis,the higher the rate of complications and mortality.RFH-GA grade was an independent influencing factor on survival time.