微型营养评定及计分的患者主观全面评定在老年卒中患者中的临床意义
The clinical significance of the mini-nutritional assessment and the scored patient-generated subjective global assessment in elderly patients with stroke.
作者信息
Kim Eun Joo, Yoon Yong Hoon, Kim Wan Ho, Lee Kwang Lae, Park Jeong Mi
机构信息
Department of Physical Medicine & Rehabilitation, National Rehabilitation Center, Seoul, Korea.
出版信息
Ann Rehabil Med. 2013 Feb;37(1):66-71. doi: 10.5535/arm.2013.37.1.66. Epub 2013 Feb 28.
OBJECTIVE
To evaluate the clinical usefulness of the subjective assessments of nutritional status (Mini-Nutritional Assessment [MNA] and scored patient-generated subjective global assessment [PG-SGA]), compared with the objective (hematological, biochemical, and anthropometric) assessments, and to identify the correlation between the MNA and the scored PG-SGA in elderly patients with stroke.
METHODS
Thirty-five stroke patients, aged 60 to 89 years old, participated in our study. The MNA, the scored PG-SGA and objective factors were evaluated. The objective malnutrition state was defined based on laboratory outcomes. According to the MNA and the scored PG-SGA classifications, total patients were respectively divided into three groups; well-nourished (W), at risk of malnutrition (R), and malnourished (M), and into four groups; normally nourished (A), suspected or mildly malnourished (B), moderately malnourished (C), and severely malnourished (D).
RESULTS
Mean age and body mass index of subjects were 70.6 years and 22.2 kg/m(2), respectively. Twenty-six (74.3%) patients were identified to be at an objectively malnourished state. In MNA, 3 (8.6%) patients were classified as group W, 13 (37.1%) as R, and 19 (54.3%) as M. Total MNA scores and three categorization had mild correlation with objective grouping (r=0.383, r=0.350, p<0.05, respectively). Restructuring into two groups by combining group R and M made strong correlation (r=0.520, p<0.01). On the basis of scored PG-SGA, 6 (17.1%) patients were sorted as group A, 10 (28.6%) as B, 15 (42.9%) as C, and 4 (11.4%) as D, respectively. Total scores and the grouping into four indicated meaningful correlation with the objective distinction (r=-0.403, p<0.05, r=0.449, p<0.01, respectively). There was a significant correlation between the MNA scores and the PG-SGA scores (r=-0.651, p<0.01).
CONCLUSION
It is proposed that the MNA and the scored PG-SGA would be useful in screening malnourished elderly patients with stroke.
目的
评估营养状况主观评估方法（微型营养评定法[MNA]和评分患者主观全面评定法[PG-SGA]）与客观评估方法（血液学、生化和人体测量学评估方法）相比的临床实用性，并确定老年卒中患者中MNA与评分PG-SGA之间的相关性。
方法
35例年龄在60至89岁之间的卒中患者参与了本研究。对MNA、评分PG-SGA和客观因素进行了评估。根据实验室检查结果定义客观营养不良状态。根据MNA和评分PG-SGA的分类，将所有患者分别分为三组：营养良好（W）、营养不良风险（R）和营养不良（M）；以及四组：营养正常（A）、疑似或轻度营养不良（B）、中度营养不良（C）和重度营养不良（D）。
结果
受试者的平均年龄和体重指数分别为70.6岁和22.2kg/m²。26例（74.3%）患者被确定处于客观营养不良状态。在MNA中，3例（8.6%）患者被归类为W组，13例（37.1%）为R组，19例（54.3%）为M组。MNA总分及三种分类与客观分组有轻度相关性（r分别为0.383、0.350，p<0.05）。将R组和M组合并为两组后相关性增强（r=0.520，p<0.01）。基于评分PG-SGA，6例（17.1%）患者被分类为A组，10例（28.6%）为B组，15例（42.9%）为C组，4例（11.4%）为D组。总分及分为四组与客观分类有显著相关性（r分别为-0.403，p<0.05；r=0.449，p<0.01）。MNA评分与PG-SGA评分之间存在显著相关性（r=-0.651，p<0.01）。
结论
建议MNA和评分PG-SGA在筛查营养不良的老年卒中患者中有用。
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