摘要
目的根据全球领导人营养不良倡议(GLIM)诊断标准,采用直接诊断和先营养风险筛查再诊断两种程序对住院恶性肿瘤患者进行营养不良诊断,探讨两种程序诊断的一致性。方法2020年1月至12月随机抽取宜宾市第一人民医院住院恶性肿瘤患者385例,分别采用直接GLIM标准诊断(一步法)和先营养风险筛查再诊断(两步法)评定患者营养不良发生情况,比较两种程序诊断营养不良的一致性。结果①恶性肿瘤患者营养风险发生率51.4%(198/385),不同年龄段、肿瘤类型及肿瘤分期营养风险发生率差异有统计学意义(P<0.05)。②GLIM标准的5个表型指标中,体重下降发生率44.4%(171/385),低体质指数(BMI)发生率17.9%(69/385),肌肉减少发生率42.3%(163/385),进食减少或消化功能障碍76.1%(293/385),疾病或炎症负担38.7%(149/385)。③按GLIM标准,“一步法”诊断营养不良阳性率51.4%(198/385),“两步法”阳性率42.6%(164/385);不管是“一步法”还是“两步法”,营养不良阳性率都有年龄段、肿瘤类型和肿瘤分期差异,年龄越大营养不良发生率越高,消化系统肿瘤高于其他肿瘤,肿瘤分期越高发生率越高(P<0.05)。④两种程序共同诊断营养不良127例,“一步法”和“两步法”诊断营养不良有较好的一致性,其Kappa值为0.44。结论恶性肿瘤患者营养风险和营养不良发生率高,GLIM营养不良诊断标准推荐的“两步法”更符合营养诊疗程序。
Objective According to global leadership initiative on malnutrition(GLIM)diagnostic criteria,two procedures of direct diagnosis and nutritional risk screening before diagnosis were used to diagnose malnutrition in hospitalized patients with malignant tumors,and to discuss the consistency of the two procedures.Methods From January to December 2020,385 patients with malignant tumors were randomly selected from the first people′s Hospital of Yibin.The incidence of malnutrition was assessed by direct GLIM criteria diagnosis(one⁃step)and nutritional risk screening and then diagnosis(two⁃step),finally the consistency of the two procedures in diagnosing malnutrition was compared.Results①The incidence of nutritional risk in patients with malignant tumors was 51.4%(198/385),and there were significant differences in the incidence of nutritional risk among different age groups,tumor types and tumor stages(P<0.05).②Among the five phenotypes of GLIM criteria,the incidence of weight loss,low body mass index(BMI),muscle loss,eating loss or digestive dysfunction and the burden of disease or inflammation was 44.4%(171/385),17.9%(69/385),42.3%(163/385),76.1%(293/385),and 38.7%(149/385)respectively.③According to the GLIM criteria,the positive rate of malnutrition diagnosed by“one−step”and"two⁃step"was 51.4%(198/385)and 42.6%(164/385)respectively.No matter"one⁃step"or"two⁃step",the positive rate of malnutrition had significant differences in age,tumor type and tumor stage.The older the age,the higher the incidence of malnutrition,digestive system tumor was higher than other tumors,and the higher the tumor stage,the higher the incidence was(P<0.05).④127 cases of malnutrition were diagnosed by the two procedures.There was a good consistency between"one⁃step"and"two⁃step"in the diagnosis of malnutrition with kappa value 0.44.Conclusion The incidence of malnutrition and nutritional risk in patients with malignant tumors is high.The"two⁃step"method recommended by GLIM is more suitable for nutritional diagn
作者
练玉颖
赵铟
Lian Yuying;Zhao Yin(Department of Oncology,the First Peoples'Hospital of Yibin,Yibin 644000,Sichuan,China)
出处
《肿瘤代谢与营养电子杂志》
2021年第5期525-529,共5页
Electronic Journal of Metabolism and Nutrition of Cancer
关键词
全球领导人营养不良倡议
恶性肿瘤
营养不良
营养风险
Global leadership initiative on malnutrition
Malignant tumors
Malnutrition
Nutritional risk
