主观全面评定和握力作为肝硬化患者的预测因素
Subjective Global Assessment and Handgrip Strength as Predictive Factors in Patients with Liver Cirrhosis.
作者信息
Ciocîrlan Maria, Cazan Andreea Ruxandra, Barbu Mihaela, Mănuc Mircea, Diculescu Mircea, Ciocîrlan Mihai
机构信息
Gastroenterology Department, Fundeni Clinical Institute, Bucharest, Romania.
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
出版信息
Gastroenterol Res Pract. 2017;2017:8348390. doi: 10.1155/2017/8348390. Epub 2017 Jul 18.
BACKGROUND AND AIMS
Malnutrition is common in patients with chronic liver disease. We aimed to evaluate malnutrition assessment tools in predicting severity and survival of patients with liver cirrhosis.
MATERIAL AND METHODS
We examined patients with liver cirrhosis. Nutritional evaluation was performed on admission, using subjective global assessment (SGA), handgrip strength (HGS), and anthropometry. Patients were followed up for 6 months.
RESULTS
We included 100 patients, 72 men, with mean age of 59.2 years. According to disease severity, patients were 23% Child-Pugh A, 46% Child-Pugh B, and 31% Child-Pugh C. SGA and HGS significantly correlated with Child-Pugh, MELD, and MELD-Na scores on admission. At 6 months follow-up, 80.4% (78 of 97) of patients survived, while 3 patients were lost from observation. Survival was predicted by SGA (1 death in 32 patients SGA A, 8 deaths in 46 patients SGA B, and 9 deaths in 19 patients SGA C, = 0.001) and HGS (25.1 ± 8.5 in deceased versus 30.6 ± 10.9 in survivors, = 0.046). The mean BMI and MAMC values did not significantly differ between patients who survived or were deceased at 6 months.
CONCLUSION
HGS and SGA may predict severity and short-term survival in cirrhotic patients.
背景与目的
营养不良在慢性肝病患者中很常见。我们旨在评估营养不良评估工具对肝硬化患者严重程度和生存情况的预测能力。
材料与方法
我们对肝硬化患者进行了检查。入院时采用主观全面评定法（SGA）、握力（HGS）和人体测量学进行营养评估。对患者进行了6个月的随访。
结果
我们纳入了100例患者，其中男性72例，平均年龄59.2岁。根据疾病严重程度，患者中Child-Pugh A级占23%，Child-Pugh B级占46%，Child-Pugh C级占31%。入院时SGA和HGS与Child-Pugh、终末期肝病模型（MELD）及MELD-Na评分显著相关。在6个月的随访中，80.4%（97例中的78例）患者存活，3例失访。SGA（SGA A级的32例患者中有1例死亡，SGA B级的46例患者中有8例死亡，SGA C级的19例患者中有9例死亡，P = 0.001）和HGS（死亡患者为25.1±8.5，存活患者为30.6±10.9，P = 0.046）可预测生存情况。6个月时存活或死亡的患者之间，平均体重指数（BMI）和上臂中部肌肉周长（MAMC）值无显著差异。
结论
HGS和SGA可预测肝硬化患者的严重程度和短期生存情况。
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