CAJ | 학술논문

目的：简易营养评价法（MNA）是专为老年人设计的营养评估方法，而营养风险筛查2002（NRS2002）常用于住院患者，本研究探讨哪一种营养评估方法更适用于老年住院患者。方法本研究纳入了179名在内科老年病房住院的≥65岁的老年患者，分别应用MNA简表（MNA-SF）和NRS2002进行营养风险评估，比较两种筛查方法的评估结果以及对临床营养治疗的指导作用，并分析与传统的临床营养指标相关性。结果 MNA-SF评估，营养不良危险者55例，营养不良者42例，总的营养风险异常率54.2%，较NRS2002筛查（有营养风险69例，38.5%）差异有统计学意义。MNA-SF筛查的营养不良危险组和营养不良组的营养治疗率分别为29.1%和50.0%，而NRS2002的营养风险组的营养治疗率为49.3%。常用的营养指标体质量指数（BMI）、体质量变化、血清白蛋白和前白蛋白与两种营养评估结果的相关性低（r＝0.09～0.48），上述指标的异常对营养风险筛查结果无可靠的提示作用。结论内科住院老年患者的营养风险筛查，同一个患者群体MNA-SF可发现较多具有营养风险的患者，而NRS2002筛查结果异常对营养治疗的指导意义更大。常用的营养指标如BMI、血清蛋白不是可靠的营养风险筛查指标。
목적：간역영양평개법（MNA）시전위노년인설계적영양평고방법，이영양풍험사사2002（NRS2002）상용우주원환자，본연구탐토나일충영양평고방법경괄용우노년주원환자。방법본연구납입료179명재내과노년병방주원적≥65세적노년환자，분별응용MNA간표（MNA-SF）화NRS2002진행영양풍험평고，비교량충사사방법적평고결과이급대림상영양치료적지도작용，병분석여전통적림상영양지표상관성。결과 MNA-SF평고，영양불량위험자55례，영양불량자42례，총적영양풍험이상솔54.2%，교NRS2002사사（유영양풍험69례，38.5%）차이유통계학의의。MNA-SF사사적영양불량위험조화영양불량조적영양치료솔분별위29.1%화50.0%，이NRS2002적영양풍험조적영양치료솔위49.3%。상용적영양지표체질량지수（BMI）、체질량변화、혈청백단백화전백단백여량충영양평고결과적상관성저（r＝0.09～0.48），상술지표적이상대영양풍험사사결과무가고적제시작용。결론내과주원노년환자적영양풍험사사，동일개환자군체MNA-SF가발현교다구유영양풍험적환자，이NRS2002사사결과이상대영양치료적지도의의경대。상용적영양지표여BMI、혈청단백불시가고적영양풍험사사지표。
ObjectiveToinvestigate which one out of the2 most commonly used tools for screening malnutrition,Mini Nutritional Assessment(MNA, speciallydesigned for the elderly)andnutritionalriskscreening2002 (NRS 2002, usually for inpatients) ismore suitable forthe geriatric inpatients.MethodsA total of179inpatientsover 65 years oldfrom geriatric wardin our hospital from July 2010 to January 2012were enrolled in this study. All the patients were assessed with MNA-short form (SF) and NRS2002 within 48h after admission. The coincidence of the2 toolswas studied,and their efficiencyofguidingthe patientsfor nutritional support was compared. Meanwhile,the relationshipof the nutritional status screened by the2 methods with traditionally used nutritional indicators,i.e.body mass index(BMI), serum albumin and pre-albumin was analyzed.ResultsBy MNA-SF, 55 cases (30.7%) were rated as at risk of malnutrition, and 42 cases (23.5%) were as malnutrition, which were significantly different from the results by NRS2002 (69 cases as at risk of nutrition, 38.5%). MNA-SF hadanefficiency of 29.1% for the patientsat risk of malnutrition, and of 50% for those of malnutrition, and NRS 2002 had an efficiency of 49.3%.Besides, the commonly used nutritional indicators BMI, serum albumin and pre-albumin showed littlecorrelation with the results rated by MNA-SF and NRS2002 (r=0.09 to 0.48),indicating that these indicatorshad no reference value fornutritional risks screening.Conclusion In the nutritional risks screening for geriatric inpatients in department of internal medicine,MNA-SF is a relatively sensitive tool for screening nutritional risks,while,NRS2002 has abetter value in the guidance for thepatients needing for nutritional therapy. Theconventionallyused nutritional indicators such as BMI, serum albumin and pre-albumin are not reliable or effective factorsfor screening nutritional risks in the elderly.