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三种方法评估造血干细胞移植前白血病患者的营养状况。

Three methods assess nutritional status of leukemia patients before hematopoietic stem cell transplantation.

机构信息

Department of Clinical Nutrition, Peking University People's Hospital, Beijing 100044, China.

出版信息

Chin Med J (Engl). 2012 Feb;125(3):440-3.

Abstract

BACKGROUND

Some leukemia patients before hematopoietic stem cell transplantation (HSCT) have nutritional risk or undernutrition, which was one of the main reasons that caused series of complications during transplantation. The aim of this study was to find out some appropriate methods to learn about the nutritional status of leukemia patients before HSCT.

METHODS

Nutritional status of patients with leukemia was assessed with three common methods of nutritional assessment (nutritional risk screening 2002 (NRS2002), mini nutritional assessment (MNA) and subjective global assessment (SGA)) before HSCT. The assessment results of NRS2002 and MNA were compared by paired χ(2) test. The consistency was analyzed by Kappa test.

RESULTS

In this study, 13 of 50 patients (26.0%) with leukemia had nutritional risk before HSCT assessed by NRS2002, including 7 patients (14.0%) with undernutrition. Of 50 patients assessed by SGA, only 1 case (2.0%) was mild or moderate undernutrition, and the remaining 49 patients (98.0%) were well-nutrition. Assessed by MNA, 1 case (2.0%) was undernutrition, 11 cases (22.0%) were potential undernutrition, and 38 cases (76.0%) were well-nutrition. Paired χ(2) test results showed that the difference between NRS2002 and MNA was statistically significant (χ(2) = 13.64, P < 0.05); Kappa test results showed that they were consistent between NRS2002 and MNA (Kappa = 0.62, P < 0.05).

CONCLUSIONS

It is important to know the nutritional status of patients with leukemia before HSCT, and NRS2002 should be the first choice of nutritional assessment for patients with leukemia. If NRS2002 and MNA used at the same time, the accuracy and comprehensiveness of the assessment can be improved.

摘要

背景

一些接受造血干细胞移植(HSCT)前的白血病患者存在营养风险或营养不良,这是移植过程中发生一系列并发症的主要原因之一。本研究旨在寻找一些合适的方法来了解 HSCT 前白血病患者的营养状况。

方法

采用营养风险筛查 2002(NRS2002)、微型营养评估(MNA)和主观整体评估(SGA)三种常用的营养评估方法,对 HSCT 前的白血病患者进行营养状况评估。采用配对 χ(2)检验比较 NRS2002 和 MNA 的评估结果,采用 Kappa 检验分析一致性。

结果

本研究中,50 例白血病患者中,NRS2002 评估有营养风险者 13 例(26.0%),其中营养不良 7 例(14.0%)。50 例患者行 SGA 评估,仅 1 例(2.0%)为轻中度营养不良,其余 49 例(98.0%)为营养良好。行 MNA 评估,营养不良 1 例(2.0%),潜在营养不良 11 例(22.0%),营养良好 38 例(76.0%)。配对 χ(2)检验结果显示,NRS2002 与 MNA 比较差异有统计学意义(χ(2) = 13.64,P < 0.05);Kappa 检验结果显示,两者一致性较好(Kappa = 0.62,P < 0.05)。

结论

了解 HSCT 前白血病患者的营养状况非常重要,NRS2002 应作为白血病患者营养评估的首选方法。如果同时使用 NRS2002 和 MNA,可以提高评估的准确性和全面性。

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