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摘要：
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摘要：目的 探讨不同营养筛查工具在肝病患者营养状况评估中的应用价值。方法 选取2018年8月1日至
2019年3月1日西安交通大学医学院第二附属医院收治的214例肝病患者为研究对象，通过身体质量指
数（body mass index，BMI）、营养不良风险筛查量表（NRS2002）、生物化学指标（血清白蛋白、血
红蛋白、前白蛋白）分别评估肝病患者的营养状况，比较不同评估方法间的差异。结果 不同营养筛查
指标显示肝病患者营养不良的发生率分别为BMI 23.36%，NRS2002 38.79%，白蛋白45.79%，血红蛋白
43.46%，前白蛋白85.05%。Spearman相关性分析显示，白蛋白与前白蛋白的相关性最高（r = 0.3591，
P ＜ 0.0001），BMI与NRS2002评分的相关性较高（r = 0.3537，P = 0.0001），NRS2002评分与白蛋
白、血红蛋白及前白蛋白的相关系数分别为0.2693、0.1921、0.2262（P值分别为0.0321、0.0411、
0.0031）。上述指标在肝硬化患者中筛查营养不良发生率均较非肝硬化患者高，其中两组BMI、
白蛋白与前白蛋白差异有统计学意义（χ 2 值分别为7.909、4.098、6.313，P值分别为0.005、0.043、
0.012）。除了BMI在不同性别肝病患者营养状况筛查中有统计学差异（χ 2 = 8.677，P = 0.003），其
余各筛查指标对不同年龄、性别肝病患者的营养状况筛查均未见明显差异（P ＞ 0.05）。结论 BMI、
NRS2002和生物化学指标（血清白蛋白、血红蛋白、前白蛋白）有明显相关性，均可用于临床肝病患
者的营养评估；但NRS2002简便易行，重复性好，适用范围较广，较其他指标临床操作性强。
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Abstract: Objective To analyze the value of different nutritional screening tools on the evaluation of
nutritional status of patients with liver diseases. Methods Total of 214 patients with liver diseases in the
Second Affiliated Hospital of Medical College, Xian Jiaotong University From August 1st, 2018 to March
1st, 2019 were enrolled. Body mass index (BMI), malnutrition risk screening (NRS2002) and biochemical
indicators (serum albumin, hemoglobin and pre-albumin) were used to assess the nutritional status of patients
with liver disease, and the differences among different assessment methods were furtherly compared. Results
Different nutritional screening indicators showed that the incidence of malnutrition in patients with liver
diseases were 23.36% for BMI, 38.79% for NRS2002, 45.79% for albumin, 43.46% for hemoglobin and
85.05% for prealbumin, respectively. Correlation analysis showed that albumin had the highest correlation
with prealbumin (r = 0.3591, P ＜ 0.0001), the correlation between BMI and NRS2002 score was higher
(r = 0.3537, P = 0.0001), and the correlation coefficients of NRS2002 score with albumin, hemoglobin and
prealbumin were 0.2693, 0.1921 and 0.2262, respectively (P = 0.0321, 0.0411, 0.0031). Hierarchical analysis
showed that the positive rate of the above indicators in patients with cirrhosis was higher than that in non-
cirrhotic patients. BMI, albumin and prealbumin had significant statistical differences between the two groups
(χ 2 = 7.909, 4.098, 6.313; P = 0.005, 0.043, 0.012). Except for BMI, which was statistically different in the
screening of nutritional status of patients with liver disease of different genders (χ 2 = 8.677, P = 0.003),
the other screening indicators showed no significant difference in the screening of nutritional status among
patients with liver diseases of different ages and genders (P ＞ 0.05). Conclusions BMI, NRS2002 score
and biochemical indicators (serum albumin, hemoglobin and pre-albumin) have obvious correlation and can
be used for nutritional evaluation of patients with liver diseases. However, NRS2002 is simple and easy to
perform, and has good repeatability and a wide application range. It is clinically more operative than the other
methods.
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