GLIM标准与PG⁃SGA在肿瘤患者营养不良诊断中的应用

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摘要目的比较全球领导人营养不良倡议（GLIM）标准和患者主观整体评估（PG‐SGA）在肿瘤患者营养不良诊断中的应用。方法 2019年1月至2020年12月随机抽取核工业四一六医院肿瘤患者266例，分别采用GLIM标准和PG‐SGA量表评定患者营养不良发生情况，并比较两种方法诊断营养不良的一致性。结果 ①肿瘤患者NRS 2002评分为（3.08±1.04）分，营养风险发生率52.6%(140/266)，不同年龄段、肿瘤类型及肿瘤分期营养风险发生率差异有统计学意义（P<0.05)。②GLIM标准的5个表型指标中，体重下降、低体质指数（BMI）、肌肉减少、进食减少/消化功能障碍和疾病/炎症负担发生率分别为 44.0%、17.3%、 41.7%、69.2%和38.7%。GLIM标准诊断营养不良98例，阳性率36.8%，不同年龄段、肿瘤类型和肿瘤分期营养不良发生率差异有统计学意义（P<0.05)。③采用PG‐SGA诊断营养不良113例，阳性率42.5%，不同年龄段、肿瘤类型和肿瘤分期营养不良阳性率差异有统计学意义（P<0.05)，年龄越大营养不良发生率越高，消化系统肿瘤高于其他肿瘤，肿瘤分期越高发生率越高。④按肿瘤患者的一般情况分层，GLIM和PG-SGA诊断营养不良的一致性良好，其Kappa值为0.76。结论肿瘤患者营养风险和营养不良发生率高，GLIM标准和PG‐SGA诊断营养不良一致性良好。

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	1吴小林
	1贺丹
	1龚红霞
	2黄小明

关键词 ：全球领导人营养不良倡议, 患者主观整体评估, 肿瘤, 营养不良, 营养风险

Abstract：Objective To compare the application of global leader′s initiative on malnutrition (GLIM) and patient⁃generated subjective global assessment (PG⁃SGA) in diagnosing malnutrition among cancer patients. Methods From January 2019 to December 2020, 266 cancer patients were randomly selected from 416 Hospital of nuclear industry and assessed the incidence of malnutrition by GLIM criteria and PG⁃SGA respectively, and the consistency of two methods in diagnosing malnutrition was compared. Results ①The NRS 2002 score of cancer patients was (3.08±1.04), and the incidence of nutritional risk was 52.6% (140/266). There were significant differences of incidence of nutritional risk among different age groups, tumor types and tumor stages (P<0.05). ②Among the five phenotypes of GLIM, the incidence of weight loss, low BMI, muscle loss, decreased food intake/digestive dysfunction and disease/inflammatory burden were 44.0%, 17.3%, 41.7%, 69.2% and 38.7% respectively. The incidence rate of malnutrition assessed by GLIM criteria was 36.8%. There were significant differences of incidence of malnutrition among different age groups, tumor types and tumor stages (P<0.05). ③113 cases of cancer patients were diagnosed malnutrition by PG⁃SGA with the incidence rate 42.5%. There were significant differences of malnutrition incidence among different age groups, tumor types and tumor stages (P<0.05). The older age, the higher incidence of malnutrition, digestive system tumors were higher than other tumors, and the higher tumor stage, the higher incidence of malnutrition. ④The consistency of GLIM and PG⁃SGA was good to diagnose malnutrition stratified according to the general situation of tumor patients. A total of 90 cases of cancer patients was diagnosed malnutrition by GLIM and PG⁃SGA. The two methods were consistent in diagnosing malnutrition with the Kappa value 0.76. Conclusion The incidence of malnutrition and nutritional risk is high among cancer patients. There is a good consistency between GLIM and PG⁃SGA in diagnosing malnutrition, but more prospective studies are needed to confirm it.

Key words： Global leaders′ initiative on malnutrition Patient?generated subjective global assessment Cancer; Malnutrition Nutritional risk

收稿日期: 2020-06-15

基金资助:四川省卫健委课题(18PJ575，20PJ226) 四川省养老与老年健康协同创新项目(YLZBZ2024)

通讯作者: 黄小明，电子邮箱：huaxi1979@126.com

引用本文:

1吴小林，1贺丹，1龚红霞，2黄小明. GLIM标准与PG⁃SGA在肿瘤患者营养不良诊断中的应用[J]. 肿瘤代谢与营养电子杂志, 2021, 8(4): 430-407.
1WuXiaolin,1HeDan,1GongHongxia,2HuangXiaoming. Application of global leadership initiative on malnutrition and patient⁃generated subjective global assessment in diagnosing malnutrition among cancer patients. Electron J Metab Nutr Cancer, 2021, 8(4): 430-407.