中国版患者主观整体评估:最可能实现肿瘤患者营养状况自我评估的工具

Chinese version of patient-generated subjective global assessment:the most likely tool to achieve self-assessment of nutritional status of eaneer patents

营养不良在肿瘤患者中普遍存在,但是目前国际上尚无评估营养状况的金标准。患者主观整体评估(PG-SGA)是评估肿瘤患者营养状况时使用最广泛的工具。虽然其在中国已被广泛应用,但是在实际应用过程中仍存在很多不足。在先前的研究中,为了更加适应中国的医疗环境,本研究对PG-SGA进行了调整,删除了50%以上专业人员认为难以完成和与总得分相关性<0.1的项目,形成了一款适用于中国肿瘤患者的营养评估表——中国版PG-SGA(CPG-SGA)。本研究发现CPG-SGA能分出营养良好与轻度营养不良患者的生存差异,而PG-SGA则不能。CPG-SGA不但简便易行,而且其中不涉及专业问题,因此问题均可由患者自我作答。本文简要介绍了3个目前常用营养问卷,着重介绍了CPG-SGA的开发及实现肿瘤患者营养状况自我评估的前景,并呼吁在国内及国际上进一步验证和改进CPG-SGA,扩大其适用范围。这必将对改善我国乃至国际肿瘤患者营养状况,提高肿瘤患者生存产生深远的影响。

Malnutrition is common in cancer patients,but there is no international gold standard for assessing nutitional status.Patient-generated subjective global assment(PC-SGA)is the most widely used tool to evaluate the nutritional status of tumor patients.Although it has been widely used in China,there are still many deficiencies in practice.In our previous study,we adjusted the PG-SGA to better adapt to the medical enviroument in China.After deleted items that more than 50%professionals think it is difcult to be finished;items with item-total correlation<0.1,the new Chinese PG-SGA(CPG-SGA)was constructed.The CPG-SGA has better descrimative validity than PG-SGA in that survival diference in patients.without malntrition and mild malnutrition can be detected by CPG-SGA but not PG-SGA.Questions in CPC-SGA require no professional knowledge and may be answered by most patients.We also develop a web-based CPG-SGA questionnaire.It is readily available and convenient to answer by patient themselves.We brielly discused three commonly used nutrition questionnaires in this review,highlighring the possibility to use CPG-SGA as a new standard.We advocate and calls for researches to test and validate the prospect of CPG-SGA in China and.abroad.This will undoubtedly have a profound impact on improving the nutitional status of cancer patients in China and even intemationally,thus enbancing their chances of survival.