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| GLIM标准在维持性血液透析患者营养风险评估中的应用 |
| Application of GLIM diagnostic criteria in assessment of nutritional risk in patients with maintenance hemodialysis |
| 投稿时间：2022-12-11 |
| DOI：10.3969/j.issn.1000-0399.2023.09.007 |
| 中文关键词: 维持性血液透析 蛋白质-能量消耗 全球领导人营养不良倡议标准 营养不良-炎症评分 |
| 英文关键词: Maintenance hemodialysis Protein-energy wasting Global leadership initiative on malnutrition Malnutritioninflammation score |
| 基金项目:2021年首都医科大学附属北京康复医院科研发展专项（编号：2021-040） |
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| 中文摘要: |
| 目的 探讨全球领导人营养不良倡议标准（GLIM标准）对维持性血液透析（MHD）患者蛋白质-能量消耗（PEW）的诊断作用。方法 选择2021年1~12月在北京康复医院血液净化中心规律进行MHD治疗的MHD患者70例，同时使用GLIM、营养不良炎症评分（MIS）和国际肾脏营养与代谢学会（ISRNM） PEW标准诊断PEW，比较3种方法诊断PEW患病率的差异，收集患者一般资料、实验室指标和营养相关生化指标等，比较金标准、GLIM与MIS的一致性；以金标准为参照，对比GLIM与MIS的准确率、灵敏度和特异度。结果 基于GLIM、MIS与金标准，MHD患者PEW患病率分别为24.3%、28.6%和30%。3种方法对PEW的诊断一致性较高（Fleiss Kappa=0.643，P<0.001）；营养相关生化指标在3种诊断方法下比较，差异无统计学意义（P>0.05）；以金标准为参照，GLIM诊断PEW的准确率和特异度分别为76.47%和91.84%，均高于MIS的70%和87.76%。结论 GLIM与金标准和传统方法MIS一致性良好，以金标准为参照，GLIM的准确率和特异度均高于MIS，是预测MHD患者PEW更准确和特异的方法。 |
| 英文摘要: |
| Objective To explore the application of Global Leadership Initiative on Malnutrition(GLIM Criteria) in diagnosis of protein energy wasting(PEW) of patients with maintenance hemodialysis(MHD). Methods Seventy patients with MHD were selected and conducted with GLIM、MIS and gold standard for PEW diagnosis made by ISRNM, and the difference in morbidity was compared. General medical history and laboratory tests of MHD patients were collected and consistency of gold standard、GLIM and MIS was compared. The differences in nutrition-related biochemical indicators of patients diagnosed as PEW between the three methods were compared. The accuracy, sensitivity, and specificity of GLIM and MIS were compared using the gold standard. Results 24.3%, 28.6% and 30% of MHD patients exhibited PEW respectively using GLIM, MIS and ISRNM gold standard. There was a good consistency in diagnosing PEW between the three methods(Fleiss Kappa=0.643, P<0.001). There was no significant difference in nutrition-related biochemical indicators or anthropometric metrics between patients diagnosed with the three methods(P>0.05). Based on the gold standard, the accuracy and specificity of GLIM was 76.47% and 91.84%respectively, higher than 70% and 87.76% of MIS. Conclusions GLIM has a good consistency with MIS and gold standard, the accuracy and specificity are both higher than MIS, so it is a more accurate and specific method in the diagnosis of PEW of MHD patients. |
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