目的 比较微型营养评定( MNA-SF) 和全球领导人营养不良倡议(GLIM) 标准在住院老年慢性阻塞性肺疾病 (COPD)患者营养不良诊断中的一致性。 方法 采用方便抽样选取 2020 年 1 月至 2021 年 12 月于宜宾市第二人民医院住院老 年 COPD 患者 489 例,采用 MNA-SF 和 GLIM 标准进行营养不良评估,并分析其结果的一致性。 结果 采用 MNA-SF 诊断营养 良好、营养不良风险和营养不良者分别为 172 例(35. 17%)、228 例(46. 63%)和 89 例(18. 20%),不同年龄段、是否合并慢性 病及病程 MNA-SF 评分和营养不良情况差异有统计学意义(P<0. 05)。 通过营养风险筛查 2002(NRS 2002)得到营养风险发 生率为 50. 31%,GLIM 标准诊断营养不良发生率为 28. 83%,<70 岁患者营养风险和营养不良发生率高于≥70 岁患者,合并慢 性病患者营养风险和营养不良发生率高于未合并慢性病患者,病程越长营养风险和营养不良发生率越高( P < 0. 05)。 MNA-SF 和 GLIM 标准诊断营养不良的 Kappa 值为 0. 675,NRS 2002 与 MNA-SF 诊断营养不良风险的 Kappa 值为 0. 619,将MNA-SF 与 GLIM 诊断的营养不良等级进行相关性分析,其 Kappa 值为 0. 348(P<0. 05)。 结论 住院老年 COPD 患者营养风险和营养不良发生率高,MNA-SF 和 GLIM 标准均可用于住院老年 COPD 患者营养不良诊断。

Objective To compare the consistency of mini nutritional assessment short form MNA- SF and global leadership initiative on malnutrition GLIM criteria in nutritional assessment among elderly inpatients with chronic obstructive pulmonary disease COPD . Method From January 2020 to December 2021 489 elderly COPD inpatients were randomly selected from the second peoples' hospital of Yibin to assess the nutritional status by MNA-SF and GLIM criteria respectively and to analyze the consistency of two methods. Result 172 35. 17% 228 46. 63% and 89 18. 20% patients were diagnosed good nutrition malnutrition risk and malnutrition by MNA - SF respectively. There were significant differences in MNA - SF scores and malnutrition incidence among different age groups whether combined chronic diseases and course of disease P<0. 05 . The incidence of nutrition risk screening by nutritional risk screening 2002 NRS 2002 was 50. 31% and the incidence of malnutrition diagnosed by GLIM was 28. 83%. The incidence of nutrition risk and malnutrition in <70 years old group was higher than that in ≥70 years old group. The incidence of nutrition risk and malnutrition in the group with chronic disease was higher than that in the group without chronic disease. The longer the course of disease the higher the nutrition risk and malnutrition incidence P<0. 05 . The Kappa value of malnutrition diagnosed by MNA-SF and GLIM was 0. 675 and the Kappa value of nutrition risk diagnosed by NRS 2002 and MNA-SF was 0. 619 while the Kappa value of malnutrition severity level diagnosed by MNA-SF and GLIM was 0. 348 P<0. 05 . Conclusion The nutritional risk and malnutrition rate are high among elderly COPD inpatients. MNA-SF and GLIM criteria can be used to diagnose malnutrition in elderly COPD inpatients.