不同评估方法对维持性血液透析患者营养评估的比较

摘要

Objective To study the differences of nutritional status in maintenance hemodialysis (MHD)patients assessed by Subjective Global Assessment (SGA), Malnutrition Inflammation Score (MIS) and Mini Nutritional Assessment-Simple Form (MNA-SF).Methods SGA, MIS and MNA-SF were used to assess the nutritional status in 120 MHD patients, and correlations were analyzed among the results from the 3 methods.Receiver operating characteristic (ROC) curve was applied to study the sensitivity and specificity of the 3 methods for the evaluation of malnutrition status.Results A strong correlation existed among SGA, MIS and MNASF (P ＜ 0.01).Area under the ROC curve of MNA-SF and MIS was 0.342 and 0.689, respectively, for malnutrition diagnosed by SGA score of ＜ 25.When the MIS score was ＞6.5, the sensitivity (70.00％) and specificity (61.70％) was highest.Conclusion MIS is similar to SGA for malnutritional assessment in MHD patients.MNA-SF is unsuitable for this purpose, neither for the assessment in elderly (age ) 60 years) MHD patients.I%目的 研究主观综合性营养评估(subjective global assessment,SGA)、营养不良- 炎症评分(malnutrition inflammation score,MIS)和微型营养评定简表(mini nutrition assessmentshort form,MNA-SF)3种方法用于维持性血液透析(maintenance hemodialysis,MHD)患者营养评估的差异.方法 M H D 患者1 2 0 例,对其进行问卷调查、体格检查,分别计算S G A 、M I S 和M N A - S F 营养评分,进行营养评分的两两相关性分析,并根据SGA ＜ 25 分为营养不良标准,对MIS、MNA-SF 行受试者工作特征(ROC)曲线分析.结果相关性分析发现SGA、MIS 和MNSA-SF 之间有显著相关性(P ＜ 0.01).MNA-SF 的ROC 曲线下面积为0.342,MIS 的ROC 曲线下面积0.689,当MIS 为6.5 分时,敏感性(70.00%)、特异性(61.70%)最高.结论 MIS 用于MHD 患者的营养评估效果与SGA 相似,MNA-SF 不适用于MHD 患者,同样不适用于老年(年龄≥ 60 岁)MHD 患者.