【摘要】 目的:比较三种营养筛查工具对血液透析病人透析相关性蛋白质-能量消耗(PEW)的预测作用,以筛选出一种快速、准确和易行的方法。方法:采用营养风险筛查2002(NRS 2002)、7分主观整体评估(7分SGA)、营养不良炎症评分(MIS)三种筛查工具对205例行维持性血液透析病人进行PEW患病率调查。同时,将三种筛查工具与人体测量指标、血生化指标等进行相关性分析,并与国际肾脏营养与代谢学会(ISRNM)制订的PEW诊断金标准进行比较。结果:根据ISRNM标准,31.2%的透析病人存在PEW,基于MIS、7分SGA、NRS 2002的评价标准,透析病人PEW的患病率分别为58.0%、40.8%和46.8%。三种筛查工具均与血生化和人体测量学指标呈明显相关关系(P<0.05),其中NRS 2002与常用客观营养指标的复合相关系数最大(r=0.787,P<0.001),相关性最为密切。在透析病人中,NRS 2002有较高的灵敏度和正确指数,分别为87.5%和59.1%。结论:对透析病人,MIS、7分SGA、NRS 2002三种筛查工具均有较好的准确性,以NRS 2002更优。NRS 2002可能是预测透析病人PEW更快速、准确、易行的营养筛查工具。更多还原

【Abstract】 Objective: To compare three nutritional screening tools in predicting dialysis-related protein-energy wasting(PEW) among maintenance hemodialysis(MHD) patients and to find a more rapid,accurate,and feasible screening tool. Methods: The nutrtional risk screening 62002(NRS 2002),7-point subjective global assessment(SGA) and malnutrition inflammation scores(MIS) were compared among 205 MHD patients. Correlations between the serum biochemistry,anthropometry and different screening tools were analyzed,and comparisons were made with established guidelines by International Society of Renal Nutrition and Metabolism(ISRNM) for PEW. Results: A total of 31. 2% of HD patients had PEW by ISRNM criteria,whilst using NRS 2002,7-point SGA and MIS,58%,40. 8% and46. 8% of MHD patients exhibited PEW respectively. The results of three screening tools were closely related to those by serum biochemistry and anthropometry(P < 0. 05),but the composite correlation coefficient between the screening tools for PEW and the objective nutritional index commonly used was higher in NRS 2002(r = 0. 787,P < 0. 001) than in 7-Point SGA or MIS. NRS 2002 had higher sensitivity and accuracy values(87. 5% and 59. 1%,respectively) in MHD Patients. Conclusion: MIS,7-Point SGA and NRS 2002 are valid tools for nutrition screening of dialysis patients,and NRS 2002 may be the best one.更多还原