患者全面主观营养评定和营养风险筛查2002在消化系统肿瘤患者营养评估中的应用比较

摘要

目的:比较营养风险筛查2002(NRS 2002)和患者全面主观营养评估(PG-SGA)在消化系统肿瘤中的应用.方法:收集2016年1月-2017年12月于十堰市太和医院住院治疗的消化系统肿瘤患者680例,分别用NRS 2002和PG-SGA评价患者营养状况,记录实验室检查结果,并分析其诊断结果的相关性.结果:消化系统肿瘤患者营养风险和营养不良发生率分别为38.2％和36.2％;不同年龄段、肿瘤类型和TNM分期的肿瘤患者NRS 2002/PG-SGA评分及营养风险/营养不良发生率差异有统计学意义,营养风险/营养不良发生率随年龄和TNM分期增加而增高,胃癌和结直肠癌高于其他类型消化系统肿瘤(P＜0.05);以白蛋白(ALB)为“金标准”判断营养不良,NRS 2002和PG-SGA与ALB判断结果有较高的一致性,其约登指数分别为0.667和0.751;NRS 2002与PG-SGA判断结果一致性高,列联系数r为0.49.结论:消化系统肿瘤营养风险/营养不良发生率高,随年龄和TNM分期增加而增高,NRS 2002和PG-SGA均可用于肿瘤患者营养状况评估.%[Objective] To compare the application of nutritional risk screening 2002 (NRS 2002) and patient-generated subjective global assessment (PG-SGA) in nutritional assessment among digestive tumor patients.[Method] From January 2016 to December 2017,680 patients with digestive tumor were collected from Taihe hospital of Shiyan to assess their nutritional status by NRS 2002 and PG-SGA,then laboratory indexes were recorded for next diagnosis,finally the relationship among diagnostic results were compared.[Resuh] The nutritional risk and malnutrition incidence rate were 38.2％ and 36.2％ among patients with digestive tumor.The differences of NRS 2002/PG-SGA score,nutritional risk/malnutrition incidence were significant with different age brackets,tumor types and TNM stages,the nutritional risk/malnutrition incidence rate were increasing with age and TNM stage,gastric cancer and colorectal cancer were significantly higher than other digestive tumors (P ＜0.05).Diagnosed malnutrition according to albumin as golden standard,the results of NRS 2002 and PG-SGA were highly consistent with albumin with Youden's index at 0.667 and 0.751 respectively.The results of NRS 2002 was consistent with PG-SGA with coefficient of contingency at 0.49.[Conclusion] The incidence rate of nutritional risk/malnutrition is high among digestive tumor patients,increasing with age and TNM stages.NRS 2002 and PG-SGA are good nutritional assessment tools for tumor patients.