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NRS2002与RFH-NPT营养风险筛查工具对失代偿期肝硬化住院患者的适用性

The applicability of NRS2002 and RFH-NPT nutritional risk screening tools in hospitalized patients with decompensated liver cirrhosis
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摘要 目的评价英国皇家自由医院营养优先工具(Royal Free Hospital nutritional prioritizing tool,RFH-NPT)与营养风险筛查方法2002(nutritional risk screening 2002,NRS-2002)工具对失代偿期肝硬化住院患者的适用性。方法选取2023年10月至2023年12月在首都医科大学附属北京地坛医院肝病科住院的202例失代偿期肝硬化患者为研究对象,使用主观全面评定(subjective global assessment,SGA)、NRS-2002和RFH-NPT营养风险筛查工具同时对研究对象进行营养风险筛查和评估。以SGA结合实验室指标作为金标准,绘制受试者工作特征(receiver operator characteristic,ROC)曲线,评价NRS-2002和RFH-NPT对失代偿期肝硬化患者营养筛查的价值。结果纳入的202例患者中贫血发生率为47.52%(96/202),低蛋白血症发生率为92.08%(186/202),淋巴细胞计数低下发生率为90.59%(183/202)。SGA联合实验室指标、RFH-NPT、NRS-20023种营养风险筛查显示,失代偿期肝硬化患者中存在营养不良/营养风险占比分别为31.19%(63/202)、51.49%(104/202)、38.61%(78/202)。RFH-NPT营养风险筛查工具的敏感度和特异度分别为93.65%和67.63%,ROC曲线下面积为0.81;NRS-2002营养风险筛查工具敏感度和特异度分别为68.25%、74.82%,ROC曲线下面积为0.72,RFH-NPT营养风险筛查工具的ROC曲线下面积显著高于NRS-2002(Z=2.41,P=0.016)。结论与NRS-2002营养风险筛查工具相比,RFH-NPT营养风险筛查工具更适用于失代偿期肝硬化患者的营养风险筛查。 Objective To evaluate the applicability of Royal Free Hospital-nutritional prioritizing tool(RFH-NPT)and nutritional risk screening 2002(NRS-2002)tools for nutritional risk screening in hospitalized decompensated liver cirrhosis patients.Methods A total of 202 hospitalized patients with decompensated liver cirrhosis in Department of Hepatology,Beijing Ditan Hospital,Capital Medical University from October 2023 to December 2023 were selected.The NRS-2002,RFHNPT and subjective global assessment(SGA)were used to screen and assess the nutritional risk of the patients.SGA combined with laboratory indicators was used as the gold standard.The receiver operator characteristic(ROC)curve was used to evaluate the effects of NRS-2002 and RFH-NPT on nutritional screening for patients with decompensated cirrhosis.Results Among the 202 patients,the incidence of anemia,hypoalbuminemia and low lymphocyte count were 47.52%(96/202),92.08%(186/202)and 90.59%(183/202),respectively.According to the SGA,RFH-NPT and NRS-2002,the proportions of malnutrition/nutritional risk in patients with decompensated liver cirrhosis were 31.19%(63/202),51.49%(104/202)and 38.61%(78/202),respectively.The sensitivity and specificity of RFH-NPT tool were 93.65%and 67.63%,respectively,and the area of the ROC curve was 0.81.The sensitivity and specificity of NRS-2002 tool were 68.25%and 74.82%,respectively,and the area of the ROC curve was 0.72.The area under the ROC curve of the RFH-NPT nutritional risk screening tool was significantly higher than that of NRS-2002(Z=2.41,P=0.016).Conclusions The RFH-NPT is more suitable for nutritional risk screening in patients with decompensated liver cirrhosis than the NRS-2002.
作者 迟学彭 任新华 张耀庭 张驰 陈璎珞 王琦 Chi Xuepeng;Ren Xinhua;Zhang Yaoting;Zhang Chi;Chen Yingluo;Wang Qi(Department of Clinical Nutrition,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of Hepatology Division 1,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)
出处 《中国肝脏病杂志(电子版)》 CAS 2024年第3期65-68,共4页 Chinese Journal of Liver Diseases:Electronic Version
基金 北京市医院管理中心青年人才培养青苗项目(QML20231803)。
关键词 肝硬化 失代偿期 皇家自由医院营养优先工具 营养风险筛查方法2002 主观全面评定 Liver cirrhosis,Decompensated Period Royal free hospital-nutritional prioritizing tool Nutritional risk screening 2002 Subjective global assessment
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