NRS2002与RFH-NPT营养风险筛查工具对失代偿期肝硬化住院患者的适用性

作者：迟学彭1  任新华2  张耀庭1  张驰1  陈璎珞1  王琦2

单位：1. 首都医科大学附属北京地坛医院 临床营养科 北京 100015 2. 首都医科大学附属北京地坛医院 肝病一科 北京 100015

关键词：肝硬化 失代偿期 皇家自由医院营养优先工具 营养风险筛查方法2002  主观全面评定

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出版年,卷(期):页码：2024,16(3):65-68

摘要：

摘要：目的 评价英国皇家自由医院营养优先工具（Royal Free Hospital nutritional prioritizing tool，RFH-NPT）与营养风险筛查方法2002（nutritional risk screening 2002，NRS-2002）工具 对失代偿期肝硬化住院患者的适用性。方法 选取2023年10月至2023年12月在首都医科大学 附属北京地坛医院肝病科住院的202例失代偿期肝硬化患者为研究对象，使用主观全面评定 （subjective global assessment，SGA）、NRS-2002和RFH-NPT营养风险筛查工具同时对研究 对象进行营养风险筛查和评估。以SGA结合实验室指标作为金标准，绘制受试者工作特征 （receiver operator characteristic，ROC）曲线，评价NRS-2002和RFH-NPT对失代偿期肝硬化患 者营养筛查的价值。结果 纳入的202例患者中贫血发生率为47.52%（96/202），低蛋白血症 发生率为92.08%（186/202），淋巴细胞计数低下发生率为90.59%（183/202）。SGA联合 实验室指标、RFH-NPT、NRS-2002 3种营养风险筛查显示，失代偿期肝硬化患者中存在 营养不良/营养风险占比分别为31.19%（63/202）、51.49%（104/202）、38.61%（78/202）。 RFH-NPT营养风险筛查工具的敏感度和特异度分别为93.65%和67.63%，ROC曲线下面积为 0.81；NRS-2002营养风险筛查工具敏感度和特异度分别为68.25%、74.82%，ROC曲线下面 积为0.72，RFH-NPT营养风险筛查工具的ROC曲线下面积显著高于NRS-2002（Z = 2.41，P = 0.016）。结论 与NRS-2002营养风险筛查工具相比，RFH-NPT营养风险筛查工具更适用于失代 偿期肝硬化患者的营养风险筛查。

Abstract: Objective To evaluate the applicability of Royal Free Hospital-nutritional prioritizing tool (RFH-NPT) and nutritional risk screening 2002 (NRS-2002) tools for nutritional risk screening in hospitalized decompensated liver cirrhosis patients. Methods A total of 202 hospitalized patients with decompensated liver cirrhosis in Department of Hepatology, Beijing Ditan Hospital, Capital Medical University from October 2023 to December 2023 were selected. The NRS-2002, RFHNPT and subjective global assessment (SGA) were used to screen and assess the nutritional risk of the patients. SGA combined with laboratory indicators was used as the gold standard. The receiver operator characteristic (ROC) curve was used to evaluate the effects of NRS-2002 and RFH-NPT on nutritional screening for patients with decompensated cirrhosis. Results Among the 202 patients, the incidence of anemia, hypoalbuminemia and low lymphocyte count were 47.52% (96/202), 92.08% (186/202) and 90.59% (183/202), respectively. According to the SGA, RFH-NPT and NRS- 2002, the proportions of malnutrition/nutritional risk in patients with decompensated liver cirrhosis were 31.19% (63/202), 51.49% (104/202) and 38.61% (78/202), respectively. The sensitivity and specificity of RFH-NPT tool were 93.65% and 67.63%, respectively, and the area of the ROC curve was 0.81. The sensitivity and specificity of NRS-2002 tool were 68.25% and 74.82%, respectively, and the area of the ROC curve was 0.72. The area under the ROC curve of the RFH-NPT nutritional risk screening tool was significantly higher than that of NRS-2002 (Z = 2.41, P = 0.016). Conclusions The RFH-NPT is more suitable for nutritional risk screening in patients with decompensated liver cirrhosis than the NRS-2002.

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