[1]邢桂枚,谢 璞,李 敏,等.探讨腰大肌指数对重症急性胰腺炎病人营养风险评估及预后判断价值[J].肠外与肠内营养杂志,2022,(02):110-115.[doi:DOI : 10.16151/j.1007-810x.2022.02.010]
　XIN Gui-mei,XIE Pu,LI Min,et al.Investigate the value of psoas major index in evaluating nutritional risk and early prognosis of patients with severe acute pancreatitis[J].PARENTERAL & ENTERAL NUTRITION,2022,(02):110-115.[doi:DOI : 10.16151/j.1007-810x.2022.02.010]
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探讨腰大肌指数对重症急性胰腺炎病人营养风险评估及预后判断价值
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2022年02期
页码:
110-115
栏目:
论著
出版日期:
2022-03-10

文章信息/Info

Title:
Investigate the value of psoas major index in evaluating nutritional risk and early prognosis of patients with severe acute pancreatitis
作者:
邢桂枚1; 谢 璞2; 李 敏1; 王润东1; 花本菊1; 明 静1
安徽省第二人民医院，1.普通外科；2.CT室，安徽合肥 230041
Author(s):
XIN Gui-mei1;  XIE Pu2;  LI Min1;  WANG Run-dong1;  HUA Ben-ju1;  MING Jing1
1. Department of General Surgery；2. Department of Computer Tomography Room；Anhui No. 2；Provincial People's Hospital, Hefei 230041, Anhui, China
关键词:
腰大肌指数 ; 急性重症胰腺炎 ; 营养风险评估 ; 预后价值
Keywords:
Psoas major index;  Acute severe pancreatitis;  Nutritional risk assessment;  Prognostic value
分类号:
R459.3，R657.5+1
DOI:
DOI : 10.16151/j.1007-810x.2022.02.010
文献标志码:
A
摘要:
目的：探讨腰大肌指数(PMI)对重症急性胰腺炎(SAP)病人发生营养风险的评估及预后的判断价值。 方法：回顾性分析安徽省第二人民医院普通外科 2014年 1月 1日至 2021年 11月 31日收治的 81名 SAP病人。调取病人腹部 CT影像资料并采集病人第 3腰椎水平腰大肌截面积，计算 PMI。将 PMI的下四分位(P25)值作为临界点划分低 PMI组(< P25)与常规 PMI组(≥ P25)，观察两组病人的一般基线情况及预后等差异。调取病人营养风险筛查资料，将营养风险筛查(NRS 2002)评分≥ 3分的病人纳入有营养风险组，< 3分纳入非营养风险组。运用 Pearson分析 PMI与营养风险发生的相关性。采用 Logistic回归分析 SAP病人发生营养风险的相关因素。 结果：两组病人一般资料比较未见明显差异(P > 0.05)。低 PMI组病人血红蛋白、白蛋白、前白蛋白水平明显低于常规 PMI组，第 7 天急性生理与慢性健康评分(APACHE II评分)及序贯器官衰竭评分(SOFA评分)明显高于常规 PMI组(P < 0.05)。低 PMI组病人胰腺感染性坏死、肺炎、多器官功能障碍(MODS)发生率较常规 PMI组高，ICU住院时间较常规 PMI组延长(P < 0.05)。 相关性分析显示，病人 PMI 值与营养风险评分呈负相关关系(r = -0.677，P = 0. 000)。多因素Logistic回归分析结果提示前白蛋白及白蛋白水平降低、APACHE II(7d)评分升高及 PMI值降低是 SAP病人发生营养风险的独立危险因素。 结论：PMI用于 SAP病人营养风险评估及预后的判断有一定价值。
Abstract:
Objective: To investigate the value of psoas major index (PMI) in evaluating nutritional risk and early prognosis of patients with severe acute pancreatitis (SAP). Methods: From January 1, 2014 to November 31, 2021,the Clinical Data of 81 SAP patients in anhui No. 2 provincial People’s hospital were analyzed retrospectively. The CT imaging system was used to collect the sum of psoas major cross-sectional area of the third lumbar spine and calculate PMI. The lowest quartile (P25) of the PMI was selected as the critical point to divide the low PMI group (< P25) and the normal group (≥ P25) . Compare the baseline situation and prognosis of two groups. The Nutritional risk screening scale (NRS 2002) was used to evaluate the nutritional risk of SAP patients and the patients with total score ≥ 3 points were included in nutritional risk group, < 3 points was included in the non-nutrition risk group. Pearson correlation analysis was used to explore the correlation between PMI and NRS 2002. Logistic regression was used to analyze the related factors of nutritional risk in SAP patients. Outcomes: There was no significant difference in baseline data between the two groups(P > 0.05). The levels of hemoglobin, albumin and prealbumin in the low PMI group were significantly lower than those in the normal PMI group, and the APACHE II score (7 d) and SOFA score (7 d) in the low PMI group were significantly higher than those in the normal PMI group (P < 0.05). The incidence of pancreatic infectious necrosis,pneumonia and multiple organ dysfunction in the low PMI group was higher than that in the normal PMI group, also the length of ICU stay in low PMI group was longer than that in the normal PMI group (P < 0.05). The Pearson correlation analysis showed a negative correlation between the PMI values and the nutritional risk score in SAP patients(r = -0.677,P = 0. 000). Multivariate logistic regression analysis showed that lower prealbumin and albumin level, higher APACHE II score (7d) and lower PMI were independent risk factors for nutritional risk in SAP patients. Conclusions: PMI has value in nutritional risk assessment andprognosis judgment of SAP patients.

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备注/Memo

备注/Memo:
基金项目 ：安徽医科大学科研基金(2020xkj084) 作者简介 ：邢桂枚，副主任护师，护理本科，主要从事外科护理工作。E-mail: 824673196@qq.com
更新日期/Last Update: 1900-01-01