改良营养不良通用筛查工具在炎症性肠病患者中的应用研究

Research on the application of modifiable malnutrition universal screening tool in patients with inflammatory bowel disease

目的探讨炎症性肠病(IBD)患者专用的改良营养不良通用筛查工具(mMUST)的应用效果。方法选取江阴市人民医院2023年2—4月收治的IBD非手术患者82例,分别使用mMUST和营养风险筛查2002(NRS 2002)对患者进行筛查。结果mMUST和NRS 2002筛查IBD患者营养风险一致性较好(Kappa=0.806,P<0.05),IBD患者使用mMUST筛查出低营养风险者34例(41.46%),中等风险12例(14.63%),高风险36例(43.90%);NRS 2002筛查无风险者57例(69.51%),高风险者25例(30.49%)。两种筛查高风险患者比例比较,差异无统计学意义(χ^(2)=3.058,P=0.076)。mMUST筛查出中高营养风险组体重指数(BMI)、握力、血红蛋白、总蛋白、血清白蛋白、前白蛋白值均低于低营养风险组;中高营养风险组C反应蛋白(CRP)>5 mg/L的比率和粪钙卫蛋白>50μg/g的比率均高于低营养风险组,差异有统计学意义(P<0.05);以营养风险等级作为因变量,采用二分类logistic回归分析探讨IBD患者营养风险的相关因素结果显示,BMI和前白蛋白是营养风险的影响因素。结论mMUST适用于IBD患者营养风险筛查,值得临床推广。

Objective To investigate the application effect of modifiable malnutrition universal screening tool(mMUST)in patients with inflammatory bowel disease(IBD).Methods A total of 82 non-surgical patients with IBD admitted to Jiangyin People’s Hospital from February to April 2023 were selected,and the patients were screened by mMUST and nutritional risk screening 2002(NRS 2002),respectively.Results The consistency of mMUST and NRS 2002 in screening nutritional risk of patients with IBD was relatively good(Kappa=0.806,P<0.05).A total of 34 cases(41.46%)of patients with IBD were screened for low nutritional risk using mMUST,12 cases(14.63%)for moderate risk,and 36 cases(43.90%)for high risk.A total of 57 cases(69.51%)were screened for no risk using NRS 2002,and 25 cases(30.49%)for high risk.There was no statistically significant difference in the proportion result of high-risk patients between the two screening methods(χ^(2)=3.058,P=0.076).The mMUST screening showed that the body mass index(BMI),grip strength,hemoglobin,total protein,serum albumin,and prealbumin in the moderate and high nutritional risk group were all lower than those in the low nutritional risk group.The ratios of C reaction protein(CRP)>5 mg/L and fecal calprotectin>50μg/g in the moderate and high nutritional risk group were all higher than those in the low nutritional risk group,with statistically significant differences(P<0.05).Using the level of nutritional risk as the dependent variable,binary logistic regression analysis was used to investigate the related factors of nutritional risk in patients with IBD.The results showed that BMI and prealbumin were the impacting factors of nutritional risk.Conclusion mMUST is suitable for nutritional risk screening of patients with IBD,and is worthy of clinical promotion.