慢性丙型肝炎病毒相关肝硬化患者控制营养（CONUT）评分与临床标志物的关系。
The Relationship between Controlling Nutritional (CONUT) Score and Clinical Markers among Adults with Hepatitis C Virus Related Liver Cirrhosis.
机构信息
Division of Hepatobiliary and Pancreatic disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
出版信息
Nutrients. 2018 Aug 29;10(9):1185. doi: 10.3390/nu10091185.
AIMS
To identify the relationship between the Controlling Nutrition Status (CONUT) score and clinical parameters among adults with hepatitis C virus (HCV)-related liver cirrhosis (LC) ( = 264, 141 males and 123 females).
METHODS
The relationship between the CONUT score and clinical variables such as Child-Pugh classification were investigated. We also examined factors linked to poor nutritional state as determined by CONUT score.
RESULTS
According to the CONUT score, normal nutritional state was found in 57 patients, mild malnutrition state in 132, moderate malnutrition state in 68 and severe malnutrition state in 7. The CONUT score ranged from 0 to 9 (median = 2) in Child-Pugh A ( = 198), 0 to 10 (median = 6) in Child-Pugh B ( = 62) and 6 to 9 (median = 7.5) in Child-Pugh C ( = 4) (overall, < 0.00001). Multivariate analysis revealed that FIB-4 index, branched-chain amino acid to tyrosine ratio and extracellular water to total body water ratio in bioimpedance analysis were significant for both CONUT score 2 or more, and 5 or more. FIB-4 index had the highest predictability for both CONUT score 2 or more and 5 or more among three parameters.
CONCLUSION
The CONUT score well reflects liver functional reserve among adults with HCV-related LC. FIB-4 index can be useful for malnutrition.
目的
确定控制营养状况（CONUT）评分与丙型肝炎病毒（HCV）相关肝硬化（LC）成人（n = 264，141 名男性和 123 名女性）临床参数之间的关系。
方法
研究了 CONUT 评分与临床变量（如 Child-Pugh 分级）之间的关系。我们还检查了与 CONUT 评分确定的营养不良状态相关的因素。
结果
根据 CONUT 评分，57 例患者营养状况正常，132 例患者轻度营养不良，68 例患者中度营养不良，7 例患者重度营养不良。Child-Pugh A 级患者的 CONUT 评分为 0 至 9（中位数 = 2）（n = 198），Child-Pugh B 级患者为 0 至 10（中位数 = 6）（n = 62），Child-Pugh C 级患者为 6 至 9（中位数 = 7.5）（n = 4）（总体，<0.00001）。多变量分析显示，FIB-4 指数、支链氨基酸与酪氨酸比值和生物电阻抗分析中的细胞外水与总体水比值对于 CONUT 评分≥2 和≥5 均具有显著意义。FIB-4 指数在预测 CONUT 评分≥2 和≥5 方面的预测能力均高于其他两个参数。
结论
CONUT 评分能很好地反映 HCV 相关 LC 成人的肝功能储备。FIB-4 指数可用于评估营养不良。
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