主观整体评价、传统营养评分和机体组成分析:对3种肝硬化营养评价方法的比较

作     者：Figueiredo F.A.F. Perez R.M. Freitas M.M. Kondo M. 廖新华 

作者机构：Internal Medicine Department Rio de Janeiro State University Rua Humait282 Rio de Janeiro 22261001Brazil 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第11期

页      面：41-42页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：营养评价 组成分析 营养评估 体细胞质量 多室模型 二室模型 人体测量法 血液检验 营养状态 

摘      要：Background. Liver cirrhosis affects the results of many of the traditional techniques currently used to evaluate nutritional status. Our aim was to compare the traditional two-compartment model (subjective global assessment and anthropometry and blood tests) of nutritional assessment with a multicompartmental model (body composition analysis) in patients with cirrhosis. Methods. Seventy-nine patients and 17 control subjects were studied. Subjective global assessment, anthropometry and blood tests, and body composition analysis were performed for each. The two most important compartments were body cell mass and total body fat. The subjects were classified by each method as well nourished or moderately or severely malnourished. Results. Twenty-five patients (31.6%) were malnourished according to the subjective global assessment, 2 (6.3%) with Child’s class A cirrhosis, 10 (34.5%) with class B, and 13 (72.2%) with class C, whereas 24 (30.4%) were malnourished according to the traditional model, 5 (15.6%) in the Child’s A group, 8 (27.6%) in B, and 11 (61.1%) in C. According to the multicompartmental model, 48 patients (60.1%)were malnourished, 11 (34.4%) in Child’s A, 20 (69%) in B, and 17 (94.4%) in C. The use of the multicompartmental model increased the prevalence of malnutrition by more than 60%in Child’s classes A and B patients and by more than 20%in Child’s class C patients. Conclusions. Traditional nutritional assessment, although easier, underestimated the prevalence and severity of malnutrition in patients with cirrhosis. The underestimation was more pronounced in Child’s class A and B patients.