NRS-2002与PG-SGA在中晚期肿瘤患者营养筛查及评估中的应用

Application of NRS-2002 and PG-SGA in nutritional screening and evaluation of patients with medium and advanced stage tumors

目的 研究欧洲营养风险筛查工具(NRS-2002)与主观整体评估量表(PG-SGA)在中晚期肿瘤患者营养筛查及评估中的应用效果。方法 回顾性分析2020年1月至2022年1月长安医院收治的116例中晚期肿瘤患者的临床资料,根据其在入院后接受的营养状况筛查和评估结果的不同分为营养正常组72例和营养不良组44例。比较两组患者的NRS-2002与PG-SGA评分情况、NRS-2002与PG-SGA不同分组患者的营养指标水平、应用NRS-2002与PG-SGA评分分组后两组患者近期的疗效及远期生存情况;采用Spearman秩相关分析法分析NRS-2002与PG-SGA评分与中晚期肿瘤患者营养指标的相关性。结果 营养正常组患者的NRS-2002与PG-SGA评分分别为(2.07±0.79)分、(3.52±1.01)分,明显低于营养不良组的(4.69±0.74)分、(5.22±1.14)分,差异均有统计学意义(P<0.05);NRS-2002评分中营养正常组患者的基础代谢、总水分、体质量指数、腰臀比、血红蛋白、白蛋白、前白蛋白、红细胞计数、血糖等营养指标水平明显高于营养不良组,PG-SGA评分中营养正常组的基础代谢、总水分、体质量指数、腰臀比、血红蛋白、白蛋白、前白蛋白、红细胞计数、血糖等营养指标水平也明显高于营养不良组,差异均有统计学意义(P<0.05);经Spearman秩相关分析法分析结果显示,NRS-2002和PG-SGA评分均与患者体质量指数、红细胞计数、血红蛋白、白蛋白、前白蛋白呈负相关(P<0.05);营养正常组患者的近期总有效率为94.44%,明显高于营养不良组的70.45%,差异有统计学意义(P<0.05);营养正常组患者的中位生存时间为(12.86±2.27)个月,明显长于营养不良组的(8.26±1.41)个月,生存率为93.06%,明显高于营养不良组的65.91%,而局部复发和远处转移率分别为16.67%、6.94%,明显低于营养不良组患者的34.09%、34.09%,差异均具有统计学意义(P<0.05)。结论 NRS-2002与PG-SGA均是筛查和评估中晚期肿瘤患者营养状态的有效方法,能及时发现患者的营养风险,以便及时对患者营养不良状况进行纠正,值得临床推广应用。

Objective To investigate the application effect of the European Nutritional Risk Screening Tool(NRS-2002)and Patient-Generated Subjective Global Assessment(PG-SGA)in nutritional screening and evaluation of patients with medium and advanced stage tumors.Methods A retrospective analysis was conducted on the clinical data of 116 patients with medium and advanced stage tumors admitted to Chang'an Hospital from January 2020 to January 2022.According to the different nutritional screening and evaluation results they received after admission,they were di-vided into a normal nutrition group of 72 cases and a malnutrition group of 44 cases.The NRS-2002 and PG-SGA scores of two groups,the nutritional index levels of patients in different groups of NRS-2002 and PG-SGA,the short-term efficacy and long-term survival of the two groups after grouping using NRS-2002 and PG-SGA scores were observed and compared.Spearman rank correlation analysis was used to analyze the correlation between NRS-2002,PG-SGA scores and nutritional indicators of patients with advanced tumors.Results The NRS-2002 and PG-SGA scores of normal nutrition group were(2.07±0.79)points and(3.52±1.01)points,which were significantly lower than(4.69±0.74)points and(5.22±1.14)points of malnutrition group(P<0.05).The levels of basal metabolism,total water,body mass index,waist hip ratio,hemoglobin,albumin,prealbumin,red blood cell count,blood sugar in NRS-2002 score of normal nutrition group were significantly higher than those of malnutrition group,while the levels of basal me-tabolism,total water,body mass index,waist hip ratio,hemoglobin,albumin,prealbumin,red blood cell count,blood sugar in PG-SGA score of normal nutrition group were significantly higher than those of malnutrition group,and statisti-cally significant differences(P<0.05).Spearman rank correlation analysis showed that NRS-2002 and PG-SGA scores were negatively correlated with body mass index,red blood cell count,hemoglobin,albumin(P<0.05).The short-term to-tal effective rate of normal nutrition group was 94.44%,which was significantly higher than 70.45%in malnutrition group(P<0.05).The median survival time of normal nutrition group was(12.86±2.27)months,which was significantly longer than(8.26±1.41)months in malnutrition group;the survival rate of normal nutrition group was 93.06%,which was sig-nificantly higher than 65.91%in malnutrition group;the local recurrence and distant metastasis rates were 16.67%and 6.94%,which were significantly lower than 34.09%and 34.09%in malnutrition group;the differences were statis-tically significant(P<0.05).Conclusion NRS-2002 and PG-SGA are both effective methods for screening and evalu-ating the nutritional status of patients with medium and advanced stage tumors,which can timely identify the nutritional risks of patients and correct their malnutrition status,and are worthy of clinical promotion and application.