摘要
目的探讨老年营养风险指数(GNRI)、预后营养指数(PNI)、前白蛋白(PAB)水平与老年髋部骨折营养风险和营养不良预后的关系。方法选取2020年1月—2022年12月240例老年髋部骨折,收集临床资料,术后随访1年,根据营养风险筛查评分分为营养风险组(≥3分)、营养正常组(<3分),对比手术前后PAB、GNRI、PNI水平,分析PAB与GNRI、PNI的相关性。根据再喂养综合征发生情况分为预后良好组和预后不良组,受试者工作特征曲线分析术前PAB、GNRI、PNI及联合对患者营养不良预后预测价值。结果营养风险组术前及术后3、6、9、12个月PAB、GNRI、PNI水平均低于营养正常组(P<0.05,P<0.01)。术前及术后3、6、9、12个月PAB均与对应时间点的PNI、GNRI呈明显正相关性(P<0.05,P<0.01)。预后不良组术前及术后3、6、9、12个月PAB、GNRI、PNI水平均低于预后良好组(P<0.05,P<0.01)。各指标联合预测老年髋部骨折预后不良的曲线下面积(0.835)大于术前PAB、GNRI、PNI单独预测的曲线下面积(0.623、0.615、0.623)。结论GNRI、PNI、PAB水平与老年髋部骨折营养风险和预后密切相关,对预后营养不良具有一定预测价值。
Objective To investigate the relationship between the geriatric nutritional risk index(GNRI),prognostic nutritional index(PNI),and prealbumin(PAB)levels and the nutritional risk and prognosis of malnutrition in elderly hip fracture patients.Methods A total of 240 elderly patients with hip fractures from January 2020 to December 2022 were selected,and clinical data were collected.They were followed up for one year after surgery and divided into nutritional risk group(≥3 scores)and normal nutrition group(<3 scores)according to the nutritional risk screening score.The levels of PAB,GNRI,and PNI were compared before and after surgery,and the correlation of PAB with GNRI and PNI was analyzed.According to the occurrence of refeeding syndrome,the subjects were divided into good prognosis group and poor prognosis group.The receiver operating characteristic(ROC)curve analysis was used to analyze the prognostic value of preoperative PAB,GNRI,PNI,and their combination for malnutrition in patients.Results The levels of PAB,GNRI,and PNI in the nutritional risk group were lower than those in the normal nutrition group before surgery and at 3,6,9,and 12 months after surgery(P<0.05,P<0.01).The levels of PAB before surgery and at 3,6,9,and 12 months after surgery were significantly and positively correlated with PNI and GNRI at the corresponding time points(P<0.05).The levels of PAB,GNRI,and PNI in the poor prognosis group were lower than those in the good prognosis group before surgery and at 3,6,9,and 12 months after surgery(P<0.05,P<0.01).The area under the ROC curve(AUC)of all indicators in combination for predicting poor prognosis of elderly hip fracture patients(0.835)was much larger than that predicted by preoperative PAB,GNRI,and PNI alone(0.623,0.615,0.623,respectively).Conclusion The levels of GNRI,PNI,and PAB are closely related to the nutritional risk and prognosis of elderly hip fracture patients,and have certain predictive value for malnutrition in prognosis.
作者
秦晗
段锦涛
郝棚娜
耿琳娜
陈玲玲
QIN Han;DUAN Jintao;HAO Pengna;GENG Linna;CHEN Lingling(Department of Nutrition,the First Hospital of Handan City,Handan,Hebei 056000,China;Department of Orthopedics and Joints,the First Hospital of Handan City,Handan,Hebei 056000,China;Department of Rehabilitation Medicine,Handan Central Hospital,Handan,Hebei 056000,China)
出处
《临床误诊误治》
CAS
2024年第6期30-35,共6页
Clinical Misdiagnosis & Mistherapy
基金
河北省2024年度医学科学研究课题计划(20240838)。
关键词
髋部骨折
老年人
营养风险
预后
前白蛋白
老年营养风险指数
预后营养指数
预测
Hip fracture
Elderly
Nutritional risk
Prognosis
Prealbumin
Geriatric nutritional risk index
Prognostic nutritional index
Prediction
作者简介
秦晗,硕士研究生,主治医师。主要从事临床营养学方向研究;通讯作者:陈玲玲,E-mail:hdyyk5109@163.com。
