Linn B S
Veterans Administration Medical Center, Miami, Florida 33125.
Am Surg. 1987 Nov;53(11):628-31.
Skin testing is useful in nutritional assessment because decreased immunity is associated with malnutrition. Absence of positive reactions indicates anergy, reaction to one test shows some decreased immunity, and response to two or more tests is considered normal. Variation in number and type of test antigens could lead to contradictory results. Also, conventional intradermal injections vary in antigen strengths, injection techniques, and subjective evaluations, and are also uncomfortable. This study compared results from three, four, or seven antigens in relation to other nutritional indices. Fifty hospitalized men with cancer were assessed with a 23 item Protein Energy Malnutrition Scale and classified as well nourished (60%) or malnourished (40%). Number of tests did not differ in identifying the malnourished; however, the smaller battery misclassified the normal as malnourished twice as often as the seven tests. Misclassification of normal as abnormal could lead to unnecessary interventions, such as total parenteral nutrition, that increase complications and cost of care dramatically.
皮肤测试在营养评估中很有用，因为免疫力下降与营养不良有关。无阳性反应表明无反应性，对一项测试有反应表明免疫力有所下降，而对两项或更多项测试有反应则被视为正常。测试抗原的数量和类型的变化可能导致相互矛盾的结果。此外，传统的皮内注射在抗原强度、注射技术和主观评估方面存在差异，而且也会让人感到不适。本研究比较了三项、四项或七项抗原的测试结果与其他营养指标的关系。对50名住院癌症男性患者用23项蛋白质能量营养不良量表进行评估，并分为营养良好（60%）或营养不良（40%）。在识别营养不良患者方面，测试数量并无差异；然而，较少的一组测试将正常者误分类为营养不良的频率是七项测试的两倍。将正常误分类为异常可能会导致不必要的干预措施，如全胃肠外营养，这会显著增加并发症和护理成本。
