摘要
目的根据心力衰竭患者体液潴留的疾病特点,研制适用于心力衰竭患者的特异性微型营养评价量表(Mini-Nutrition Assessment Special for Heart Failure,MNA-HF),并检验其信效度。方法连续纳入252例慢性心力衰竭患者,在微型营养评价量表(Mini-Nutrition Assessment,MNA)的基础上研制MNA-HF:以备选条目为自变量,MNA评价结果为因变量,建立L ogistic回归模型。根据每个条目的权重(回归系数),删除无统计学意义的条目,并重新赋予剩余条目相应分值。以白蛋白为参照,根据R OC曲线划分MNA-HF营养评价的临界值,形成最终版的M NA-HF。最后评价MNA-HF的信效度,包括对心力衰竭患者营养评价的准确性及不良临床结局的预测性。结果经过统计测试,确定了15个最佳条目,总分为0~29分;营养状态临界值划分如下:评分≥22分表示营养正常,16分≤评分<22分表示存在营养不良风险,评分<16分表示存在营养不良。信效度分析示,MNA-HF在心力衰竭患者营养筛查中的准确性较MNA高,约登指数为0.875;COX回归显示,MNA-HF对再入院率合并死亡率有独立预测作用。结论本研究改良形成的M NA-HF能够提高对慢性心力衰竭患者进行营养评价的准确性,对患者的不良临床结局具有预测作用。
Objective To develop mini-nutrition assessment tool special for heart failure（MNA-HF） and test its reliability and validity. Methods A total of 252 patients were recruited. MNA-HF was developed based on MNA： the items were entered into the logistic regression model and weighted scores were calculated according to the weighted effects of the MNA items. The efficiencies of MNA and MNA-HF were compared to predict malnutrition according to albumin. Results After testing multiple versions,we identified the MNA-HF with 15 optimal items, and total score ranging from 0 to 29. Using an MNA-HF score of 16 as normal,diagnostic accuracy was 87.5% for predicting malnutrition. In predictive analysis,MNA-HF showed a higher prognostic value for the composite endpoint of all-cause death and rehospitalization（P〈0.05）. Conclusion MNA-HF improves the accuracy of the nutritional evaluation in heart failure ,and can be independent predictors for poor clinical outcomes.
出处
《中华护理杂志》
CSCD
北大核心
2017年第2期150-153,共4页
Chinese Journal of Nursing
基金
科学技术部立项(2011BA111B00)
关键词
心力衰竭
营养评价
信度
效度
Heart Failure
Nutrition Assessment
Reliability
Validity
