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肝硬化患者的营养评估

Nutritional assessment in patients with cirrhosis.

作者信息

Fernandes Sabrina Alves, Bassani Lilian, Nunes Flávia Feijó, Aydos Maria Eugênia Deutrich, Alves Alexandro Vaesken, Marroni Cláudio Augusto

机构信息

Postgraduate Program of Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, RS, Brasil.

出版信息

Arq Gastroenterol. 2012 Jan-Mar;49(1):19-27. doi: 10.1590/s0004-28032012000100005.

Abstract

CONTEXT

Malnutrition in cirrhotic patients with end-stage disease is common, and the degree of nutritional debilitation can play an important role in the pathogenesis of complications and cause a negative impact on prognosis. However, it involves difficulties and controversies regarding the identification of the best nutritional assessment method.

OBJECTIVE

To identify a method that provides a safe and effective nutritional diagnosis.

METHODS

Cross-sectional study with 129 cirrhotic patients. Anthropometric measurements, subjective global assessment, hand grip strength and bioelectrical impedance.

RESULTS

Through phase angle of bioelectrical impedance analysis (BIA) method, significant associations with Child-Pugh (P = 0.008), age group and gender were observed. The ROC (receiver operator characteristic) curve was generated to determine the best cutoff point of the phase angle of cirrhotic patients, serving as one of the reference parameters for the nutritional assessment with bioimpedance in this study, considering the classification through Child-Pugh score as the reference standard for the clinical conditions of patients with cirrhosis.

CONCLUSIONS

The assessment through bioelectrical impedance presented a statistically significant correlation with Child-Pugh score. The identification of phase angle of 5.44º is the new parameter suggested for the classification of the nutritional conditions of cirrhotic patients.

摘要

背景

晚期肝硬化患者营养不良很常见,营养衰弱程度在并发症的发病机制中可能起重要作用,并对预后产生负面影响。然而,在确定最佳营养评估方法方面存在困难和争议。

目的

确定一种能提供安全有效营养诊断的方法。

方法

对129例肝硬化患者进行横断面研究。进行人体测量、主观全面评定、握力和生物电阻抗测量。

结果

通过生物电阻抗分析(BIA)方法的相位角,观察到与Child-Pugh分级(P = 0.008)、年龄组和性别有显著关联。绘制ROC(受试者工作特征)曲线以确定肝硬化患者相位角的最佳截断点,将通过Child-Pugh评分的分类作为本研究中肝硬化患者临床状况的参考标准,以此作为本研究中生物阻抗营养评估的参考参数之一。

结论

通过生物电阻抗进行的评估与Child-Pugh评分具有统计学上的显著相关性。建议将5.44º的相位角作为肝硬化患者营养状况分类的新参数。

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