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肝脏弹性与慢性肝病患者的营养状况的关系研究
作者:王春艳1 2 纪冬2 邵清2 李冰1 2 陈松海2 牟瑛2 宫雪2 陈国凤1 2 
单位:1.解放军医学院 北京 100853 2.解放军第302医院 北京 100039 
关键词:弹性显像技术 FibroScan 肝病 营养 营养风险 
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出版年,卷(期):页码:2015,7(1):32-36
摘要:

摘要:目的 明确肝脏弹性值与慢性肝病患者营养状况的相关性。方法 采用瞬时弹性成像(FibroScan)评价205例慢性肝病患者的肝纤维化情况,根据FibroScan值将患者分为4个不同肝纤维化组别,应用营养风险筛查表(NRS 2002)对各组患者进行营养风险筛查,主观综合性营养评估(SGA)评价其营养不良状况,使用Spearman秩相关方法分析其相关性。结果 应用NRS 2002筛查4组处于不同肝纤维阶段患者的营养风险,结果提示伴随肝纤维化程度逐渐加重,营养风险发生率增加,营养不良状况恶化,患者的握力下降,肱三头肌皮褶厚度及上臂围减少,化验白蛋白及前白蛋白、淋巴细胞计数均逐渐降低,差异均有统计学意义(P < 0.05)。存在营养风险的慢性肝病患者较无营养风险组的肝脏弹性值增高,肝硬化组符合这一特点,而肝炎组的不同营养风险患者的肝脏弹性值差异无统计学意义(P = 0.4762)。结论 不同肝脏弹性的慢性肝病患者其营养状况存在差异,营养风险以及营养不良与肝脏弹性值有关。

Abstract: Objective To clarify the relationship between liver stiffness and nutritional status of patients with chronic liver disease. Methods Liver stiffness of 205 hospitalized chronic liver disease patients were measured by transient elastography (FibroScan), and these patients were divided into four groups with different stage of liver fibrosis. Nutritional risk screening (NRS 2002) was applied to evaluate the nutrition risk of different groups of patients. Subjective global nutritional assessment (SGA) was used to determine the nutrition status of these patients. The relationship was analyzed with Spearman rank correlation. Results NRS 2002 screening showed that nutrition risk increased, nutrition status decreased when the liver fibrosis stage was getting severe, and the values of grasping power (HG), the triceps skinfold thickness (TSF), upper-arm circumference (MAC), prealbumin (PA), albumin (ALB) and total lymphocyte count (TLC) also declined, these differences were significant (P < 0.05). The liver stiffness values of cirrhotic patient with more nutrition risk were higher than those with less nutrition risk, whereas the same result wasn’t observed in hepatitis patients. Conclusions There was difference in nutrition status among chronic liver disease patients with different liver stiffness, and increased nutrition risk or malnutrition might relate to liver stiffness.

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