Nutritional assessment with different tools in leukemia patients after hematopoietic stem cell transplantation

Objective： Correct nutritional assessment is essential for leukemia patients after hematopoietic stem cell transplantation （HSCT）. This study aimed to investigate the best nutritional assessment method for leukemia patients after HSCT, and find the possible nutritional risk of the patients during the transplantation process in order to intervene in the patients with nutritional risks and undernourished patients timely, so that the entire transplantation process could be successfully completed. Methods： A prospective study was performed in 108 leukemia patients after HSCT, and different nutritional assessment methods, including nutritional risk screening 2002 （NRS2002）, mini nutritional assessment （MNA）, subjective globe assessment （SGA） and malnutritional universal screening tools （MUST）, were used. The associations between nutritional status of these patients and nutritional assessment methods were analyzed. Results： A total of 108 patients completed SGA, and 99 patients completed NRS2002, MNA and MUST. During the treatment process, 85.2% of the patients lost weight, wherein, 50% lost weight greater than 5%, and 42.6% had significantly reduced food intake. For nutritional risk assessment, the positive rates of NRS2002, MNA and MUST were 100%, 74.7% and 63.6%, respectively. There was a significant difference （P〈0.05） among the positive rates of NRS2002, MNA and MUST. In undernutrition assessment, the positive rate of SGA （83.3%） was significantly higher than that of MNA （17.2%） （P〈0.05）, and the incidence rate of nutritional risk among leukemia patients _〈30 years old was greater than that of patients 〉30 years old （P〈0.05）. Conclusions： Patients with leukemia were in poor nutritional status during and after HSCT. The leukemia patients 〈30 years old had a greater incidence rate of nutritional risk. As nutritional risk screening tool, the specificity of NRS2002 is not high, but it can be used for evaluating nutritional deficiencies. MNA is a good nutritional risk screening tool, but not an adequate tool for nutritional assessment. If assessment of undernutrition is necessary, the combination of all these screening tools and clinical laboratory indicators should he applied to improve accuracy.

Assessment of the Nutritional Status of 202 Elderly People Living at Home in Sidi-Bel-Abbès (Western Algeria)

Background: Malnutrition is common for elderly representing a major public health problem with many consequences for the health. Objectives: To assess the nutritional status of a population of elderly living at home. Subjects and Methods: The assessment was conducted from a population of elderly living at home who saw their doctor in the office of a public health centre. For each subject, the anthropometric parameters (weight, height, body mass index (BMI)), biochemical (serum albumin) and Mini Nutritional Assessment (MNA) tools have been measured and calculated. Results: 202 mostly female (56.44%) subjects aged 73.59 ± 5.87 years were included in this study. 78% were suffering from chronic diseases, the most frequent of which was diabetes (32%). 7.43% of the diseased population have BMI < 21, 5.94% experienced undernutrition (MNA < 17) and 68.81% are at risk of malnutrition (MNA: 17 - 23.50). According to serum albumin, 8.91% of the sample is considered to be malnourished. Conclusion: The MNA has proven to be a screening tool more sensitive than other tools (BMI and albumin) in the evaluation of nutritional risk.

Assessment of Risk of Malnutrition in Elderly Hypertensive Patients with or without Associated Cardiovascular Risk Factors Living at Home (West Algeria) Sidi-Bel-Abbès

Undernutrition is frequently underestimated in the elderly, because clinical manifestations are non-specific. For the francophone Club geriatrics and nutrition, poly medication is one of the warning signs to be the possibility of malnutrition in an elderly person. To do this, it is particularly interesting to verify what the profiles of hypertensive patients who are at risk of malnutrition are. This component remains very little explored and studies are lacking. The authors conducted a descriptive cross-sectional study whose objective is to evaluate the prevalence of undernutrition in hypertensive patients with or without associated cardiovascular risk factors, in a population of consultants of liberal medical offices, determine the profiles of hypertensive patients who are at risk of undernutrition and describe their eating habits and their anthropometric parameters as well as the link between the number of supported antihypertensives and risk of undernutrition. 1144 patients with an average age of 65 years old have been collected during the period of recruitment. The data collection was done using a questionnaire: the MNA. Sensitive and specific, it is validated method which has international sacle. The percentage of the risk of malnutrition was estimated at 36.7%. Thus the number of associated cardiovascular risk factors becomes larger, and the risk of malnutrition is increased. The risk of malnutrition was three times higher in patients who take more than three medications per day compared with those who consumed less (75.8% vs. 24.2%). As a monotherapy, an increased risk of malnutrition is associated with diuretics. For these older hypertensives, the risk of malnutrition was linked to the type of used dual. The percentage of hypertension risk of malnutrition treated with free dual was significantly higher compared to hypertensive treated dual handset. Some associations have proved to be more favorable than others in terms of nutritional risk. Finally, a third of hypertension patients who were treated with quadruple therapy were at risk of malnutrition. This work was also designed to present an argument to a doctor to detect the risk of undernutrition in elderly hypertensives. The use of the MNA is a simple, effective and quick way for pressure balance rhymes with nutritional balance.

Nutritional Status of Elderly People Living at Home in Sidi-Bel-Abbes (West Algeria)

The aim of the study was to assess the nutritional status of a cohort of elderly people living independently at home. 314 elderly individuals were selected during general medicine examinations. The collection of nutritional data concerned the measurement of some anthropometric parameters (body weight, height, and BMI), the Mini Nutritional Assessment (MNA) and serum albumin. The average age was 72.92 ± 6.26 years with a feminine predominance (59.55%). The BMI was 25.63 ± 4.43 Kg·m-2 and serum albumin 36.45 ± 5.77 g·L-1. 61% of the investigated population were affected by chronic diseases such as: diabetes (39%). Using the MNA as a mean of screening;46.18% of individuals presented a risk of malnutrition and 4.78% were undernourished. However, when the BMI and serum albumin were used;14.01% and 42.35% have been considered as undernourished respectively. The MNA seems to be a more sensitive tool rather than the other screening parameters (BMI and serum albumin) in the assessment of nutritional risk in the elderly.

Associations of social participation, demographic, socioeconomic and disease factors with nutritional risk in a group of older Hong Kong adults

Aims: To identify the impact of social participation, socio-demographic, socio-economic and disease factors on nutritional risk among older persons in Hong Kong. Background: Few published work has investigated the relative risks of social participation, demographic, socioeconomic and disease factors with malnutrition in community-living older people, this study is to investigate the associations of these risk factors on the nutritional status in better nutrition support for the old age group. Design: A crosssectional study. Methods: It was a secondary analysis of a database in a mobile community centre between January 2008 and December 2009. One thousand seven hundred and thirty one participants aged between 54 and 103 were collected. With 319 full Mini Nutritional Assessment (MNA) completed, the participants’ demographic, socio-economic data, diseases, and nutritional status were analyzed with relative risk and 95% confidence interval level to identify the factors that make them vulnerable to nutritional risk. Results: The prevalence of malnutrition in the community-dwelling old was 3.95% and 83.7% of the sample was at risk of malnutrition. Living on allowances, young old who was socially engaged and good relationship with family members were at less risk to malnutrition. Conclusions: Special attention should be taken to these groups as they are prone to develop malnutrition.

Elderly Persons Aged 80 Years and Older and Their Nutritional Status

A challenge for health care providers is that there will be a distinct rise globally in the number of elderly people aged 80 years and over. Malnutrition is a well-known problem among elderly people;few studies have focused on the nutritional status of those aged over 80, irrespective of whether they live in nursing homes (NHs) or in ordinary housing. The aim of the study was to examine the nutritional status of elderly people aged 80 or older. The study was cross-sectional with 64 elderly persons (80 - 100 years old) living in NHs (n = 35) or in ordinary housing (n = 29). Their nutritional status was assessed with the Mini Nutritional Assessment. Among the elderly people living in NHs, half were at risk and one fourth were suffering from malnutrition. Ten percent of the elderly persons in ordinary housing were found to be at risk;none were malnourished. Thirty-one percent had BMI values <23. The majority of the participants ate 2 - 3 meals per day and were prescribed more than three medications daily. Although not statistically significant, well-nourished participants were more likely to be married, and to rate their psychological and physical health very good/good compared to participants who were at risk of becoming malnourished or were malnourished. In conclusion, the results indicate that special attention regarding nutritional intake is required for those aged 80 years and older irrespective of type of accommodation. The RNs have a responsibility to identify the problems and needs and to implement and evaluate nutritional care in this age group. There is a further need for knowledge regarding the effects of both nutritional interventions and of their optimum timing.

NRS 2002、MNA-SF和GNRI筛查老年共病患者营养风险及与肌少症的关系

目的探讨营养风险筛查2002(NRS 2002)、微型营养评定量表简化版(MNA-SF)和老年营养风险指数(GNRI)在老年共病患者营养风险筛查中的一致性,研究共病患者营养风险与肌少症的关联性。方法选取2019年1月至2021年12月在我院住院治疗的老年共病患者268例,采用NRS 2002、MNA-SF和GNRI筛查患者营养风险,按亚洲肌少症工作组(AWGS)2019年标准进行肌少症筛查。探讨3种方法筛查营养风险的一致性及营养风险与肌少症的关系。结果NRS 2002筛查营养风险发生率为53.36%,>70岁组患者NRS 2002评分和营养风险发生率高于≤70岁组(P<0.05)。MNA-SF筛查营养良好、营养不良风险和营养不良发生率分别为27.98%、51.12%和20.90%。GNRI筛查出高、中、低和无营养风险发生率分别为11.19%、44.40%、27.62%和16.79%。3种筛查工具筛出营养风险发生率均与共病数量和共病种类有关,共病数量≥3种的营养风险发生率更高,含消耗性疾病患者营养风险高于不含消耗性疾病患者(P<0.05)。以MNA-SF≤11分、NRS 2002≥3分和GNRI≤98分定义为有营养风险,MNA-SF、GNRI与NRS 2002判定结果的kappa值分别为0.477和0.188。肌少症检出率为33.96%,NRS 2002、MNA-SF和GNRI筛查的营养风险与肌少症之间的列联系数r分别为0.433、0.323和0.152(P<0.05)。结论MNA-SF、NRS 2002和GNRI均可用于老年共病患者营养风险筛查,患者的营养风险与肌少症有关。

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

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。

不同营养评估法在老年长期卧床患者预后评价中的应用

目的探讨2种不同营养评估法在老年长期卧床患者预后评价中的应用对比。方法选择2022年1月至2022年12月接治的80例老年长期卧床患者作为本次研究对象,均采取营养风险筛查2002(NRS2002)、微型营养评估简表(MNA-SF)对患者预后营养状况评估,以膳食回顾、人体测量(BMI<18.5 kg/m^(2))和体成分分析(或白蛋白<35 g/L)等营养评定指标作为评定营养不良的标准作为金标准,并对NRS2002、MNA-SF量表与金标准评估情况进行对比,明确适合老年长期卧床患者预后营养状况的筛查方法。结果80例患者经金标准评估,其中49例判定为营养不良;NRS2002判定45例为营养不良,MNA-SF量表评定49例营养不良,与金标准对比,2组评估结果并无明显统计学差异(P<0.05)。2种营养评估方案评估营养不良发生率对比差异无统计学意义(P<0.05)。NRS2002、微型营养评估简表对患者预后营养状况评估结果显示,2种评估方案与传统血液检验指标对比差异无统计学意义(P<0.05);不同疾病长期卧床老年患者预后NRS2002评分对比差异无统计学意义(P<0.05);不同疾病长期卧床老年患者预后MNA-SF量表评分对比差异无统计学意义(P<0.05)。结论MNA-SF与NRS2002评估方案均具有全面、准确等优势,操作便捷,无创安全,评估耗时较短,可适用于老年长期卧床患者的预后营养预估。

微型营养评定简表在围手术期老年患者营养风险筛查中的应用

目的观察微型营养评定简表(mini-nutritional assessment short-form,MNA-SF)在围手术期的老年患者中的应用效果。方法选取2022年7月至2023年10月阳江人民医院的胃癌根治术患者100例,使用数字随机法将所选患者分为对照组和试验组,每组50例。试验组所有患者均在入院24h内进行MNASF营养风险筛查,对有营养不良风险的患者术前给予肠内+肠外营养干预。对照组所有患者在入院24h内采用营养风险筛查2002(nutritional risk screening 2002,NRS2002)进行营养风险筛查,对有营养不良风险的患者术前给予肠内+肠外营养干预。对比两组患者营养风险筛查的阳性率及术后康复情况。结果试验组老年患者进行营养风险筛查的阳性率高于对照组,差异有显著性(P<0.05)。试验组患者的术后下床时间、伤口愈合时间、住院时间比对照组更短,术后并发症发生率更低,差异均有显著性(P<0.05)。结论MNA-SF通过提供一个简单而全面的评估框架,有助于早期发现老年患者的营养问题并提早干预,有利于促进患者的康复。

MNA和MNA-SF评价老年人营养状况比较

目的 比较简易营养评价法 (MNA)和简易营养评价精法 (MNA SF) 2种评价老年人营养状况方法 ,以及 2种方法和传统营养指标的相关性。 方法 利用MNA、MNA SF量表对住院老年人进行调查 ,同时测定传统营养指标。 结果 MNA量表测试结果 :住院老年人营养不良患病率为 3 6 1% ;潜在营养不良的有 46 5 % ;营养正常的有 17 4% ;MNA SF量表测试结果 :住院老年人营养不良患病率为 71 5 % ;营养正常的为 2 8 5 %。MNA SF与MNA相比 ,敏感性为 85 7% ,特异性 96 0 % ,准确性 87 5 % ,相关系数为 0 93 3 ,且与传统营养指标的相关性一致。 结论 MNA与MNA SF是快捷、简便、可靠的老年营养状况评价方法 ,且MNA SF更简便、更适用于临床调查。

微型营养评定法在老年慢性阻塞性肺疾病患者中的应用及其与BODE指数的相关性

目的探讨微型营养评定法（MNA）在老年慢性阻塞性肺疾病（COPD）患者中的应用,分析其与BODE指数的相关性。方法选择2012年4月~10月南方医科大学珠江医院呼吸内科门诊稳定期COPD老年患者139例,采用MNA评估营养状态并分为营养良好组、营养风险组及营养不良组。测定患者的体测指标、肺功能、6分钟步行距离（6MWD）,采用MMRC评估呼吸困难程度。按BODE指数评分标准进行评分,并分析其与MNA评分间的相关性。结果 3组间性别构成无统计学意义（P〉0.05）,年龄及体测指标差异具统计学意义（P〈0.001）。3组间BODE指数参数FEV1%Pred、BMI、MMRC、6MWD的评分情况差异均有统计学意义（P〈0.001）。MNA评分与BODE指数呈负相关（r=-0.605,P〈0.001）。结论 MNA与体测指标、BODE指数密切相关,适用于COPD人群;营养是COPD患者症状的重要影响因素,改善营养状态是缓解症状的有效措施之一。

应用微型营养评价法及微型营养评价精法评价恶性肿瘤患者的营养状况

目的探讨微型营养评价法(MNA)及微型营养评价精法(MNA-SF)对恶性肿瘤患者营养状况的评价作用,了解其与传统营养评价指标的相关性。方法对167例恶性肿瘤患者同时应用MNA及MNA-SF进行营养评价,并且测量人体学指标和实验室指标,分析MNA及MNA-SF与传统评价指标的相关性。结果根据MNA值评定为营养不良者101例(60.5%),潜在营养不良者34例(20.4%),营养正常者32例(19.1%);根据MNA-SF值评定为营养不良者117例(70.1%),营养正常者50例(29.9%)。MNA法与MNA-SF法有高度相关性(r=0.948,P<0.01)。MNA法和MNA-SF法均与传统营养评价法中的体质指数(r=0.646、0.723)、肱三头肌皮褶厚度(r=0.493、0.571)、上臂肌围(r=0.559、0.459)、腓肠肌围(r=0.675、0.680)、血红蛋白(r=0.539、0.492)、总蛋白(r=0.634、0.555)、白蛋白(r=0.585、0.543)、前白蛋白(r=0.593、0.541)、总淋巴细胞计数(r=0.418、0.371)呈正相关(P值均<0.01)。结论恶性肿瘤患者营养不良的发生率高,MNA法和MNA-SF法均是评价恶性肿瘤患者营养状况的有效方法。

老年胃肠肿瘤患者术前营养状况及营养支持的调查与分析

目的调查并分析老年胃肠肿瘤患者的术前营养状况及营养支持情况,为临床营养管理提供科学依据。方法采用定点连续抽样法,选择2014年7月至2015年2月就诊于中南大学湘雅二医院老年外科的146例老年胃肠肿瘤拟手术治疗的患者为研究对象,运用简易营养评价精法(short-form mini nutritional assessment,MNA-SF)评估其术前营养状况,分析MNA-SF评价结果与传统营养指标的关系,同时调查患者接受营养支持的情况。结果146例患者中,营养正常者66例(45.21%),其中17例接受了营养支持。有营养问题者共80例(54.79%),其中:潜在营养不良62例(42.47%),有38例接受了营养支持;营养不良18例(12.33%),有16例接受了营养支持。营养正常、潜在营养不良和营养不良3组患者的年龄、白蛋白(albumin,ALB)、前白蛋白(pre-albumin,PA)、血红蛋白(hemoglobin,Hb)、淋巴细胞总数(LC)及身体质量指数(body mass index,BMI)经比较,差异均有统计学意义(均P<0.01)。结论老年胃肠肿瘤患者术前营养问题较为普遍,医护人员应在营养评估的基础上予以合理的营养支持,MNA-SF简便、有效,适用于老年胃肠肿瘤患者术前的营养筛查和评估。

3种营养筛查工具在老年压疮高危患者中的应用比较

目的明确微型营养评价法(mini-nutritional assessment,MNA)、微型营养评价精法(short-form mini-nu-tritional assessment,MNA-SF)和营养风险筛查方案(nutrition risk screening2002,NRS2002)对老年压疮高危患者进行营养风险筛查的适用性。方法应用3种营养筛查工具对684例消化科老年压疮高危患者进行营养风险筛查,2χ检验比较3种营养筛查工具评定结果及应用营养支持组间压疮发生率的差异;用Kappa值、敏感性及特异性分析比较3种营养筛查工具的评定效果。结果 MNA、MNA-SF、NRS2002对684例老年住院患者营养风险检出率分别为74.9%、71.1%和53.5%,3种营养筛查评定结果及应用营养支持压疮发生率组间差异均有统计学意义。以传统营养评价为标准,MNA、MNA-SF、NRS2002的灵敏性分别为92.6%、87.2%和80.1%;特异性分别为42.2%、44.5%和72.1%;Kappa值分别为0.35、0.32和0.52。以压疮发生为标准,MNA、MNA-SF和NRS2002的灵敏性分别为97.5%、94.3%和90.2%;特异性分别为30.1%、34.0%和54.5%;Kappa值分别为0.13、0.12和0.25。结论在判别营养与压疮关系方面,3种量表灵敏性相差不显著,准确性以NRS2002最高,适用于老年压疮高危患者营养风险筛查。

简易营养评估法评估老年腹膜透析患者的营养状况

目的:采用简易营养评估法(mininutritional assessment,MNA)对老年腹膜透析患者进行营养评估,并与传统的主观综合营养评估(subjective global assessment,SGA)方法进行比较。方法:采用横断面调查的方法,对我院腹膜透析中心的45例患者(60岁以上)进行问卷调查以及人体测量,分别用SGA与MNA两种方法,同时检测患者血液中白蛋白、前白蛋白水平、血常规,检测了与标化的蛋白质相当的总氮呈现率(nPNA),进行饮食调查。结果:(1)根据SGA,无营养不良22例(49%),轻至中度营养不良14例(31%),重度营养不良9例(20%);根据MNA,无营养不良18例(40%),存在营养不良风险17例(38%),营养不良10例(22%)。(2)依据SGA与MNA评分,分别在不同营养状态的三组间进行以下指标的比较:平均每日每公斤体重能量与蛋白质摄入(DEI、DPI)、血白蛋白、nPNA、透析月龄、残余肾功能,透析充分性指标(Kt/V、Ccr)差异均有显著性统计学意义(P<0.05)。但无营养不良组的DEI、DPI异常率在SGA评分时达到了64%,而MNA评分时降至28%(P<0.05);存在营养不良的两组患者,血白蛋白与前白蛋白的正常率,SGA评分时为43%与60%,MNA评分为44%与59%。存在明显营养不良时,两种评分的指标异常均明显升高。(3)无论采用SGA还是MNA方法,两种分类法的统计学结果是一致的。(4)在评估结果与各指标相关性研究中,发现SGA与MNA评分结果与一系列客观指标显著相关,MNA法较优。结论:(1)SGA与MNA皆是评价老年腹膜透析营养状况的简单有效方法,但还需结合其它的营养评估指标,如DEI、DPI、血白蛋白、前白蛋白、nPNA。(2)在某些方面,MNA评估法优于SGA评分。SGA对于评价已有的营养不良有效,而MNA更有利于早期发现需要营养干预的患者。MNA评估法简单易行,值得推广,需进一步研究。

微型营养评价法在老年心血管疾病住院患者营养不良风险评价中的应用

目的探讨微型营养评价法（MNA）在老年心血管疾病（CVD）住院患者营养不良风险评价中的应用。方法运用MNA法测定316例老年CVD住院患者的MNA总分,根据MNA总分评估患者营养状况。结果营养不良组52例（16.46%）,营养不良风险组60例（18.99%）,营养状况良好组204例（64.56%）;女性老年患者营养风险及营养不良发生率均高于男性患者,差异有统计学意义（P〈0.01）;高龄患者（≥80岁）营养风险及营养不良发生率均高于低龄患者（60-〈80岁）,但差异无统计学意义（P〉0.05）;农村患者营养风险及营养不良发生率均高于城镇居住患者,且差异有统计学意义（P〈0.05）。结论老年CVD患者营养不良风险发生率较高,可在老年CVD住院患者中应用MNA进行营养状况监测和营养不良风险的早期筛查。

预后营养指数与微型营养评估表对老年急性脑梗死患者营养状况的评估效果比较

目的比较预后营养指数(PNI)和微型营养评估表(MNA)对老年急性脑梗死患者营养状况的评估效果。方法收集120例老年急性脑梗死患者的基线资料,以患者3个月时的预后作为终点绘制PNI的受试者工作特征(ROC)曲线,确定PNI最佳截断值并分组,再应用PNI、MNA分别对患者进行营养评估,并与人体测量学指标、生化指标、功能状态指标进行相关性分析,最后评价PNI、MNA方法的一致性。结果PNI最佳截断值为50.375。120例患者中,PNI评估为营养不良者50例(41.7%),MNA评估为营养不良者57例(47.5%)。PNI与MNA评估的营养不良组或营养正常组在年龄、体质量、手臂围、小腿围、体质量减轻、体质量指数、美国国立卫生研究院卒中量表(NIHSS)评分及总淋巴细胞计数、总蛋白方面比较,差异均无统计学意义(P>0.05)。2种方法的一致性验证结果显示,PNI与MNA具有高度一致性(κ=0.647)。结论PNI与MNA对老年急性脑梗死患者营养状况具有高度一致的评估效果,其中PNI更为客观,而MNA更为主观。

握力在老年内科住院患者营养评价中的应用价值

目的探讨握力(handgrip strength,HGS)在老年内科住院患者营养评价中的价值。方法我院于2012年5月-2013年12月采用连续定点抽样,对新入院老年患者1 343例进行微型营养评价精法(mini nutritional assessment short-form,MNA-SF)评估营养状况,测量HGS、身高、体质量、体质量指数(body mass index,BMI)、腰围(waist circumference,WC)、小腿围(leg circumference,LC)及收集血红蛋白(hemoglobin,HB)、总蛋白(total protein,TP)、白蛋白(albumin,ALB)、肌酐(creatinine,Cr)、尿素氮(blood urea nitrogen,BUN)、三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)等指标。分析HGS的相关影响因素及判断营养不良的临界值。结果老年内科住院患者MNA-SF评估显示营养不良构成比为39.99%(男40.49%、女39.51%);存在营养不良的老年内科住院患者的HGS、体质量、BMI、WC、LC、ALB、TG及HB均较营养正常组人群偏低,而年龄偏高(P<0.05)。相关分析显示,优势手握力与MNA-SF评估结果有显著相关性(P<0.05),与身高、体质量、BMI、WC、LC、ALB、TP、TG、HB均呈显著正相关(P<0.05),而与年龄呈显著负相关(P<0.05)。优势手握力预测老年内科住院患者营养状况的ROC曲线下面积>0.7(P<0.05),男性患者的优势手握力<20.8 kg,女性<16.1 kg可以判断存在营养不良。结论老年内科住院患者营养不良比例较高,HGS测量简单易行且经济,可用于评估老年内科住院患者的营养状况。

营养状况与阿尔兹海默病的相关性研究

目的探讨病情严重程度不同的阿尔兹海默病（AD）患者的营养状况及与AD的相关性。方法回顾分析2011年1月～2013年6月上海中医药大学附属普陀医院收治的96例AD患者的营养状况，并与同期100例健康体检者进行比较。营养状况的调查采用微型营养评定法（MNA）及生化指标的测定。根据简易智能状态量表（MMSE）将AD患者分为轻、中、重度3组，分析病情严重程度不同的AD患者营养状况的差异。采用Spearman相关分析及多元回归分析营养指标与AD的相关性。结果AD患者营养不良的发生率高于健康体检者，MNA评分、白蛋白（ALB）低于健康体检者（P〈0．05）。中度、重度AD患者营养不良的发生率高于轻度患者，ALB低于轻度患者；重度AD患者总蛋白低于轻度、中度患者，差异有统计学意义（P〈0．05）。Spearman相关分析表明，AD患者的ALB及MNA评分与MMSE评分呈正相关（P〈0．05）；ALB与日常生活能力量表（ADL）评分呈负相关（P〈0．05）。多元回归分析表明，AD患者的MNA评分降低与MMSE评分、ADL评分呈线性相关（P〈0．05）。结论营养不良与AD疾病的发生发展密切相关。