预后营养指数与微型营养评估表对老年急性脑梗死患者营养状况的评估效果比较

崔玉环; 张婧文; 徐雅丽; 冯英慧; 杜丹; 颜娟; 连晶晶; 刘占矿; 董利平

doi:10.7619/jcmp.20213191

预后营养指数与微型营养评估表对老年急性脑梗死患者营养状况的评估效果比较

Prognostic Nutritional Index versus Mini-nutrition Assessment Form in evaluating efficacy of nutrition status in elderly patients with acute cerebral infarction

摘要

摘要:
目的比较预后营养指数（PNI）和微型营养评估表（MNA）对老年急性脑梗死患者营养状况的评估效果。
方法收集120例老年急性脑梗死患者的基线资料，以患者3个月时的预后作为终点绘制PNI的受试者工作特征（ROC）曲线，确定PNI最佳截断值并分组，再应用PNI、MNA分别对患者进行营养评估，并与人体测量学指标、生化指标、功能状态指标进行相关性分析，最后评价PNI、MNA方法的一致性。
结果 PNI最佳截断值为50.375。120例患者中，PNI评估为营养不良者50例（41.7%），MNA评估为营养不良者57例（47.5%）。PNI与MNA评估的营养不良组或营养正常组在年龄、体质量、手臂围、小腿围、体质量减轻、体质量指数、美国国立卫生研究院卒中量表（NIHSS）评分及总淋巴细胞计数、总蛋白方面比较，差异均无统计学意义（P>0.05）。2种方法的一致性验证结果显示，PNI与MNA具有高度一致性（κ=0.647）。
结论 PNI与MNA对老年急性脑梗死患者营养状况具有高度一致的评估效果，其中PNI更为客观，而MNA更为主观。

Abstract:
Objective To compare Mini-Nutrition Assessment Form (MNA) and Prognostic Nutrition Index (PNI) in evaluating efficacy of nutritional status in elderly patients with acute cerebral infarction.
Methods The baseline data of 120 elderly patients with acute cerebral infarction were collected. The receiver operating characteristic (ROC) curve of PNI was drawn based on the prognosis of patients at 3 months as the end point. The optimal cut-off value of PNI was determined and they were divided into differed groups. Then PNI and MNA were used to evaluate the nutrition of the patients, and their relationships with anthropometric indicators, biochemical indicators and functional status indicators were analyzed by correlation analysis, and consistency of PNI and MNA methods was evaluated.
Results The optimal cut-off value of the PNI was 50.375. Of 120 patients, there were 50 (41.7%) with malnutrition by PNI and 57 (47.5%) by MNA. No significant differences were found in age, body weight, arm circumference, calf circumference, weight loss, body mass index, National Institutes of Health Stroke Scale (NIHSS) score and the total number of total lymphocyte count and total protein of two groups assessed by both MNA and PNI(P>0.05). The consistency of the two methods showed that PNI was highly consistent with MNA (κ=0.647).
Conclusion PNI and MNA have a highly consistent effect in assessing the nutritional status of elderly patients with acute cerebral infarction. PNI is a more objective indicator, while MNA is a more subjective one.

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