摘要
目的 探讨不同营养评估方法在肝硬化患者中的应用价值。方法 选取我院2022年6月至2023年5月收治的肝硬化患者143例,收集患者的临床资料,应用主观全面评定(SGA)、控制营养状态评分(CONUT)及肝病患者营养评价方法(NALD)对患者进行营养评估,并以SGA为标准,计算CONUT、NALD的ROC曲线下面积、敏感度、特异度、Kappa值,进行准确度及一致性检验。结果 3种方法检测的营养不良发生率为62.9%、64.3%、60.8%,组间差异无统计学意义(P>0.05)。各方法评分与上臂肌围、三头肌皮褶厚度、白蛋白等指标呈负相关,与总胆红素、腹水量、Child-Pugh评分呈正相关。CONUT的ROC曲线下面积为0.786,诊断的准确度为中等,敏感度和特异度分别为85.6%、71.7%,Kappa值为0.577,一致性检验为中等;NALD的ROC曲线下面积为0.893,诊断的准确度为中等,敏感度、特异度分别为90.0%、88.7%,Kappa值为0.778,与SGA评估的一致性检验较好。结论 NALD更适合于肝硬化患者的营养评估。
Objective To explore application value of different nutritional assessment methods in patients with cirrhosis.Methods Total 143 patients with cirrhosis were selected,clinical data of patients were collected,and nutritional assessment of patients was performed using subjective globe assessment(SGA),controlling nutritional status score(CONUT)and nutritional assessment for liver disease(NALD).The area under ROC curve,sensitivity,specificity and Kappa values of CONUT and NALD were calculated with SGA as the standard for accuracy and consistency test.Results The incidence rates of malnutrition detected by the three methods were 62.9%,64.3%,and 60.8%,with no statistically significant differences among the groups(P>0.05).Scores of each method were negatively correlated with upper arm muscle circumference,triceps skinfold thickness,and albumin,and positively correlated with total bilirubin,ascites volume,and Child-Pugh score.The area under ROC curve of CONUT was 0.786,diagnostic accuracy was medium,sensitivity and specificity were 85.6%and 71.7%,respectively.Kappa value was 0.577,and consistency test was medium.The area under ROC curve of NALD was 0.893,diagnostic accuracy was medium,sensitivity and specificity were 90.0%and 88.7%,respectively.Kappa value was 0.778,which had a good consistency test with SGA evaluation.Conclusion NALD would be more suitable for nutritional assessment in patients with cirrhosis.
作者
夏燕飞
刘梅娟
李秀梅
施燕
连静维
赖秋宇
燕群
文静
李灵芝
Xia Yanfei;Liu Meijuan;Li Xiumei(Department of Gastroenterology and Department of Nutrition,Nanfang Hospital,Southern Medical University,Guangzhou,Guangdong 510515,China)
出处
《四川医学》
2025年第8期919-923,共5页
Sichuan Medical Journal
基金
南方医科大学南方医院院长基金(编号:2021H012)。
关键词
肝硬化
营养评估工具
营养不良
cirrhosis
nutritional assessment
malnutrition
