握力在老年内科住院患者营养评价中的应用价值

Application value of handgrip strength in nutrition assessment of elderly medical inpatients

  • 摘要: 目的 探讨握力(handgrip strength,HGS)在老年内科住院患者营养评价中的价值。 方法 我院于2012年5月- 2013年12月采用连续定点抽样,对新入院老年患者1 343例进行微型营养评价精法(mini nutritional assessment short-form,MNA-SF)评估营养状况,测量HGS、身高、体质量、体质量指数(body mass index,BMI)、腰围(waist circumference,WC)、小腿围(leg circumference,LC)及收集血红蛋白(hemoglobin,HB)、总蛋白(total protein,TP)、白蛋白(albumin,ALB)、肌酐(creatinine,Cr)、尿素氮(blood urea nitrogen,BUN)、三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)等指标。分析HGS的相关影响因素及判断营养不良的临界值。 结果 老年内科住院患者MNA-SF评估显示营养不良构成比为39.99%(男40.49%、女39.51%);存在营养不良的老年内科住院患者的HGS、体质量、BMI、WC、LC、ALB、TG及HB均较营养正常组人群偏低,而年龄偏高(P< 0.05)。相关分析显示,优势手握力与MNA-SF评估结果有显著相关性(P< 0.05),与身高、体质量、BMI、WC、LC、ALB、TP、TG、HB均呈显著正相关(P< 0.05),而与年龄呈显著负相关(P< 0.05)。优势手握力预测老年内科住院患者营养状况的ROC曲线下面积> 0.7(P< 0.05),男性患者的优势手握力< 20.8 kg,女性< 16.1 kg可以判断存在营养不良。 结论 老年内科住院患者营养不良比例较高,HGS测量简单易行且经济,可用于评估老年内科住院患者的营养状况。

     

    Abstract: Objective Toassess the application value of hand gripstrength in nutrition assessment of elderly medical inpatients. Methods A cross-sectional study was conductedin our hospital fromMay 2012 toDecember 2013, and 1343 patients were assessedby mini nutritional assessment short-form(MNA-SF) and their bloodbiochemical indicators in the 24 hours of admission, including HGS, height, weight, BMI, WC, LC, HB, TP, ALB, Cr, BUN, TG and TC, were measured. The correlation between HGS and nutritional indicators was analyzedand the dominant HGS cut points for malnutrition was estimated. Results Of all the elderly inpatients, 39.99% of them(men 40.49%, women 39.51%) hadmalnutrition by MNA-SF; The HGS, weight, BMI, WC, LC, ALB, TG and HB of malnutrition groupwere significantly lower than those of well nutrition group, but the age was significantly higher (P< 0.05); Pearson’s correlation analysis showedthat the dominant HGS was correlatedwith MNA-SF result (P< 0.05), and positively correlatedwith height, weight, BMI, WC, LC, ALB, TP, TG and HB (P< 0.05), and negatively correlatedwith age (P< 0.05). ROC curve analysis for dominant HGS and nutritional status sensitivity/specificity foundthat the area under the curve was more than 0.7, and the dominant HGS cut points for malnutrition were 20.8 kg for men and 16.1 kg for women by MNA-SF. Conclusion Elderly inpatients are associatedwith a greater incidence of malnutrition. HGS is a rapid, cost-effective and easy-to-use method, which is suitable for assessing nutritional status of elderly medical inpatients.

     

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