老年营养风险指数与溃疡性结肠炎患者远期预后的相关性

黄秀芹; 姚海欣; 张扬; 徐李娟; 诸葛玮玮; 胡婷婷

doi:10.16766/j.cnki.issn.1674-4152.004207

老年营养风险指数与溃疡性结肠炎患者远期预后的相关性

doi: 10.16766/j.cnki.issn.1674-4152.004207

温州医科大学附属第一医院消化内科护理部P122病区，浙江温州 325000

基金项目:

浙江省医药卫生科技计划项目 2023RC206

详细信息

通讯作者:
黄秀芹，E-mail：doch_wy@163.com

中图分类号: R574.62 R730.7
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出版历程
- 收稿日期: 2025-01-26

The correlation between geriatric nutritional risk index and long-term prognosis of patients with ulcerative colitis

Nursing Department, Ward 122 Department of Gastroenterology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的回顾性分析溃疡性结肠炎(UC)患者远期预后不良的危险因素，探究老年营养风险指数(GNRI)与UC患者远期预后的相关性。方法选择2020年1月1日—2021年12月31日温州医科大学附属第一医院治疗的136例UC患者，治疗3年后复查结肠镜，按照复查结果将患者分为预后良好组(92例)和预后不良组(44例)。比较2组患者的临床资料，采用Spearman相关分析研究GNRI与Mayo评分、有肠外表现、病变累及全结肠的相关性；通过多因素logistic回归分析研究影响UC患者远期预后不良的独立危险因素，采用ROC曲线分析GNRI预测UC患者远期预后不良的临床价值。结果预后良好组GNRI高于预后不良组(104.74±10.49 vs. 94.24±11.20)，Mayo评分、有肠外表现的患者比例、病变累及全结肠的患者比例均低于预后不良组[(6.74±2.18)分vs. (8.61±2.44)分、9.78%(9/92) vs. 27.27%(12/44)、11.96%(11/92) vs. 31.82%(14/44), P＜0.05]。多因素logistic回归分析显示，GNRI降低、Mayo评分升高和全结肠病变是UC患者远期预后不良的独立危险因素(P＜0.05)。ROC曲线分析显示，GNRI预测UC患者远期预后不良的曲线下面积为0.734(95% CI：0.650~0.818，P < 0.001)。结论 GNRI降低是UC患者远期预后不良的独立危险因素，可预测UC患者远期预后不良。
- 溃疡性结肠炎 /
- 老年营养风险指数 /
- 预后
Abstract: Objective To retrospectively analyze risk factors for poor long-term prognosis in patients with ulcerative colitis (UC) and to explore the correlation between the Geriatric nutritional risk index (GNRI) and the long-term prognosis of patients with UC. Methods A total of 136 patients with UC who were treated at the First Affiliated Hospital of Wenzhou Medical University from January 1, 2020 to December 31, 2021 were enrolled. Colonoscopy was reexamined after 3 years of treatment. According to the reexamination results, the patients were divided into the good prognosis group (n=92) and the poor prognosis group (n=44). The clinical data of the two groups of patients were compared. Spearman correlation analysis was used to analyze the correlations between GNRI and Mayo score, presence of extraintestinal manifestations, and lesion involvement of the entire colon, and the independent risk factors influencing the poor long-term prognosis of UC patients were analyzed through multivariate logistic regression. The clinical value of GNRI in predicting poor long-term prognosis was analyzed by using the receiver operating characteristic (ROC) curve. Results The GNRI in the good prognosis group was higher than that in the poor prognosis group (104.74±10.49 vs. 94.24±11.20). The Mayo score, the proportion of patients with extraintestinal manifestations, and the proportion of patients with lesions involving the entire colon were all lower than those in the poor prognosis group [(6.74±2.18) points vs. (8.61±2.44) points, 9.78% (9/92) vs. 27.27% (12/44), 11.96% (11/92) vs. 31.82% (14/44), P < 0.05]. Multivariate logistic regression analysis showed that decreased GNRI, elevated Mayo score, and total colonic lesions were independent risk factors for poor long-term prognosis in UC patients (P < 0.05). ROC curve analysis showed that the area under the curve of GNRI for predicting poor long-term prognosis in UC patients was 0.734 (95% CI: 0.650-0.818, P < 0.001). Conclusion The GNRI is an independent risk factor for the poor long-term prognosis of patients with UC and can predict the poor long-term prognosis of patients with UC.
- Ulcerative colitis /
- Geriatric nutritional risk index /
- Prognosis
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图 1 GNRI预测UC患者远期预后不良的ROC曲线

Figure 1. ROC curve analysis of the GNRI for predicting poor long-term prognosis in UC patients

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表 1 2组UC患者临床资料比较

Table 1. Comparison of clinical data between two groups of UC patients

项目	预后不良组(n=44)	预后良好组(n=92)	统计量	P值
GNRI(x±s)	94.24±11.20	104.74±10.49	5.344^a	< 0.001
高血压病[例(%)]	6(13.64)	12(13.04)	0.009^b	0.924
糖尿病[例(%)]	6(13.64)	14(15.22)	0.059^b	0.808
高脂血症[例(%)]	9(20.45)	20(21.74)	0.029^b	0.864
C反应蛋白(x±s, mg/L)	5.92±2.03	6.05±2.06	0.346^a	0.730
血沉(x±s, mm/h)	12.94±5.93	13.08±6.02	0.127^a	0.899
Mayo评分(x±s)	8.61±2.44	6.74±2.18	4.506^a	< 0.001
肠外表现[例(%)]			6.973^b	0.008
有	12(27.27)	9(9.78)
无	32(72.73)	83(90.22)
病变累及范围[例(%)]			7.826^b	0.005
全结肠	14(31.82)	11(11.96)
部分结肠	30(68.18)	81(88.04)
合并症[例(%)]
高血压病	10(22.73)	24(26.09)	0.178^b	0.673
糖尿病	5(11.36)	11(11.96)	0.010^b	0.920
高脂血症	6(13.64)	13(14.13)	0.006^b	0.938
注：^a为t值，^b为χ²值。

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表 2 UC患者远期预后不良影响因素的logistic回归分析

Table 2. Logistic regression analysis of factors associated with poor long-term prognosis in patients with UC

变量	B	SE	Waldχ²	P值	OR(95% CI)
GNRI	-0.109	0.026	17.575	< 0.001	0.897(0.852~0.944)
Mayo评分	0.224	0.101	4.948	0.026	1.252(1.027~1.525)
病变累及范围	1.629	0.601	7.337	0.007	5.100(1.569~16.579)
注：本表仅列出差异有统计学意义的结果。

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