营养风险筛查2002、微型营养评定简化版和老年营养风险指数在老年食管癌病人营养风险筛查中的应用

Application of nutritional risk screening 2002,mini nutritional assessment short-form,and geriatric nutritional risk index in screening nutritional risk among elderly patients with esophageal cancer

目的比较营养风险筛查2002(NRS 2002)、微型营养评定简化版(MNA-SF)和老年营养风险指数(GNRI)在老年食管癌病人营养风险筛查中的一致性。方法选取2019年1月至2021年12月宜宾市第一人民医院的老年食管癌病人160例,分别采用NRS 2002、MNA-SF和GNRI对其进行营养风险筛查,比较筛查结果的一致性。结果NRS 2002、MNA-SF和GNRI筛查的营养风险发生率分别为48.13%(77/160)、65.00%(104/160)和63.75%(102/160),NRS 2002筛查的营养风险发生率在不同年龄段、病程和是否手术治疗病人间差异有统计学意义(P<0.05),GNRI筛查的营养风险发生率接受放化疗者高于未接受放化疗者(69.49%比47.62%,P<0.05)。若以NRS 2002为“金标准”,MNA-SF和GNRI的Kappa值分别为0.59和0.54(P<0.05)。若以NRS 2002、MNA-SF和GNRI任意2种共同筛查阳性为“金标准”,NRS 2002、MNA-SF和GNRI与“金标准”筛查的Kappa值分别为0.42、0.75和0.67(P<0.05)。结论老年食管癌病人营养风险发生率高,NRS 2002、MNA-SF和GNRI均可用于老年食管癌病人营养风险筛查,但MNA-SF可能准确度更高。

Objective To compare the consistency of nutritional risk screening 2002(NRS 2002),Mini Nutritional Assessment Short-Form(MNA-SF)and geriatric nutritional risk index(GNRI)in screening nutritional risk among elderly patients with esophageal cancer(EC).Methods A hundred and sixty elderly EC patients,admitted to The First People's Hospital of Yibin from January 2019 to December 2021,were selected to screen the nutritional risk by NRS 2002,MNA-SF and GNRI respectively,and the consistency of three methods was compared.Results The incidences of nutritional risk screened by NRS 2002,MNA-SF and GNRI were 48.13%(77/160),65.00%(104/160)and 63.75%(102/160),respectively.There were significant differences in nutritional risk incidence screened by NRS 2002 among patients with different age,course of disease and those undergoing surgery or not(P<0.05).The incidence of nutritional risk screened by GNRI in patients who received radiotherapy or chemotherapy was significantly higher than that in patients who did not(69.49%vs.47.62%,P<0.05).If NRS 2002 was considered as a golden standard for screening,the Kappa values of MNA-SF and GNRI were 0.59 and 0.54,respectively(P<0.05).If any two of the three methods were considered as a golden standard for co-screening positive result,the Kappa values of NRS 2002,MNA-SF and GNRI were 0.42,0.75 and 0.67(P<0.05).Conclusions The incidence of nutritional risk was high among elderly patients with esophageal cancer.NRS 2002,MNA-SF and GNRI all could be used for nutritional risk screening of elderly patients with esophageal cancer,but MNA-SF may achieve more accurate result.