Onodera T, Goseki N, Kosaki G
Nihon Geka Gakkai Zasshi. 1984 Sep;85(9):1001-5.
Based on assessment of 200 malnourished cancer patients of digestive organs, a multiparameter index of nutritional status was defined to relating the risk of postoperative complications to base line nutritional status. The linear predictive model relating the risk of operative complication, mortality or both to nutritional status is given by the relation: prognostic nutritional index (PNI) = 10 Alb. + 0.005 Lymph. C., where Alb. is serum albumin level (g/100 ml) and Lymph. C. is total lymphocytes count/mm3 peripheral blood. When applied prospectively to 189 gastrointestinal surgical patients those who were malnourished and treated by TPN preoperatively, this index provided an accurate, quantitative estimate of operative risk. In general, resection and anastomosis of gastrointestinal tract can be safely practiced when the index is over 45. The same procedure may be dangerous between 45 and 40. In below 40, this kind of operation may be contraindicated. The prognostic nutritional index is useful also to know the prognosis of patients with terminal cancer. Despite practicing TPN to cancer patients with near terminal stages, if the PNI remains below 40 and total lymphocytes count remains below 1,000/mm3, the patients has high possibility to die within the next two months.
基于对200例消化器官营养不良癌症患者的评估，定义了一个营养状况多参数指数，以将术后并发症风险与基线营养状况相关联。将手术并发症风险、死亡率或两者与营养状况相关联的线性预测模型由以下关系式给出：预后营养指数（PNI）=10×白蛋白 + 0.005×淋巴细胞计数，其中白蛋白是血清白蛋白水平（g/100 ml），淋巴细胞计数是外周血中淋巴细胞总数/mm³。当将该指数前瞻性地应用于189例胃肠道手术患者（这些患者术前营养不良并接受了全肠外营养治疗）时，该指数提供了对手术风险的准确、定量估计。一般来说，当该指数超过45时，可以安全地进行胃肠道切除和吻合术。在45至40之间进行相同的手术可能有危险。低于40时，这类手术可能被禁忌。预后营养指数对于了解晚期癌症患者的预后也很有用。尽管对接近终末期的癌症患者实施了全肠外营养，但如果PNI仍低于40且淋巴细胞总数仍低于1000/mm³，患者在接下来的两个月内死亡的可能性很高。
