摘要
目的 本研究旨在探索全球领导人营养不良倡议(GLIM)标准在终末期肝病(ESLD)患者营养状况评估中的应用成效。方法 选取2023年3月—2024年5月天津市第二人民医院住院治疗的205例ESLD患者。对其进行人体测量、血液生化监测,利用NRS2002标准筛查入组人员的营养风险状况,并采用GLIM标准进行营养评估,研究GLIM与其他指标的相关性,通过计算灵敏度、特异度等诊断性能指标,量化GLIM标准在ESLD患者检测中诊断的准确性。结果 入院营养风险筛查205例ESLD患者中有142例(69.3%)存在营养风险(NRS2002≥3分)。利用GLIM标准诊断营养不良状况,结果发现有96例(46.8%)存在营养不良,其中中度营养不良、重度营养不良各为55例、41例,占比分别为26.8%和20.0%。在营养不良组中,测量得到患者身体质量指数(BMI)、小腿围与上臂围、皮褶厚度和握力均低于非营养不良组(P<0.05)。GLIM诊断营养不良与所选人体测量指标高度相关,尤其是BMI(r=-0.445)、皮褶厚度(r=-0.316)和上臂围(r=-0.48),此外与血液生化指标(如尿素氮、淋巴细胞计数、高密度脂蛋白、前白蛋白等)也呈现出显著相关性。结论 GLIM标准诊断评估结果可以有效地反映ESLD患者的营养状况,有望作为ESLD患者营养不良的诊断评估工具。
Objective To evaluate the value of the Global Leaders'Malnutrition Initiative(GLIM)criteria in assessing the nutritional status of patients with end-stage liver disease(ESLD).Methods Atotal of 205 ESLD patients hospitalized in Tianjin Second People's Hospital from March 2023 to May 2024 were selected for anthropometry and blood biochemical monitoring,nutritional risk screening was conducted by NRS2002,nutritional assessment was conducted by GLIM standard,and the correlation between GLIM and other indicators was analyzed and discussed,and sensitivity and specificity were calculated The diagnostic performance index quantified the accuracy of GLIM standard in diagnosing ESLD patients.Results Among 205 ESLD patients admitted to hospital for nutritional risk screening,142(69.3%)patients had nutritional risk(NRS2002≥3score).GLIM criteria were used to diagnose malnutrition,and 96 cases(46.8%)were found to be malnourished,including 55 cases(26.8%)of moderate malnutrition and 41 cases(20%)of severe malnutrition.Biceps circumference, calf circumference, body mass index (BMI),skinfold thickness and grip strength were signifi cantly lower in the malnourished group than in the non-malnourished group (P<0.05). GLIM diagnosis of malnutrition was highly correlated with selected anthropometric indicators. In particular, BMI(r=-0.445), skin fold thickness (r=-0.316) and upper arm circumference (r=-0.48) were significantly correlated with blood biochemical indices (urea nitrogen, lymphocyte count, high-density lipoprotein, prealbumin, etc.). Conclusion The results of GLIM standard diagnostic evaluation can effectively reflect the nutritional status of ESLD patients,and it is expected to be used as a diagnostic evaluation tool for malnutrition ESLD patients.
作者
裴佳佳
贺登花
张颖
张勇湛
PEI Jiajia;HE Denghua;ZHANG Ying;ZHANG Yongzhan(Departmeng of clinical Nutrition,Tianjin Second People's Hospital,Tianjin,300192,China)
出处
《中华养生保健》
2025年第18期179-184,共6页
CHINESE HEALTH CARE
基金
科技人才培育项目(RC20038)。
