[肝硬化患者营养不良的发生率:一项观察性研究]
María Cielo Gutiérrez1, Andrea Curia1, Enzo Rey1
1División de Gastroenterología. Hospital de Clínicas José de San Martín, Universidad de Buenos Aires. Ciudad Autónoma de Buenos Aires, Argentina. Universidad de Buenos Aires División de Gastroenterología Hospital de Clínicas José de San Martín Universidad de Buenos Aires Ciudad Autónoma de Buenos Aires Argentina.
在肝硬化患者中,营养不良很常见,影响死亡率. 主观的全球评估和人体测量显示出较低的一致性,这表明在肝病中用于早期检测和干预的联合使用.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 临床营养学 临床营养学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 营养不良是肝硬化患者的重要并发症,对死亡率产生负面影响.
- 了解营养不良的患病率和促成因素对于患者管理至关重要.
研究的目的:
- 通过主观的全球评估和人类测量来确定肝硬化患者营养不良的患病率.
- 分析营养不良与肝硬化严重程度 (Child-Pugh和MELD得分) 和病因之间的关系.
主要方法:
- 一组436名成年肝硬化患者 (2016年5月至2019年4月) 进行了营养评估.
- 方法包括主观的全球评估,人体测量,动力测量,以及对Child-Pugh和MELD分数的评估.
- 统计分析使用了奇平方,费舍尔精确和曼-惠特尼测试 (p <0.05).
主要成果:
- 49.5%的患者通过主观的全球评估显示营养不良,而26.1%的患者通过人体测量显示营养不良,一致性较低 (kappa = 0.25).
- 营养不良的患病率随着肝病的严重程度而增加:36.1% (CP A) 到86.5% (CP C) 通过主观的全球评估,以及20.5% (CP A) 到54% (CP C) 通过人体测量.
- 营养不良与MELD得分有显著的关联 (p < 0.0001),而酒精病因与更大的营养不良有关.
结论:
- 在肝硬化患者中,营养不良非常普遍,包括那些患有补偿疾病的人.
- 主观的全球评估和人类测量之间的低一致性凸显了对互补的诊断工具的需求.
- 早期识别营养不良对于肝硬化患者及时进行治疗干预至关重要.
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