Objective: To investigate the nutritional status of children with cerebral palsy (CP) and the clinical effectiveness of Subjective Global Nutritional Assessment (SGNA) in nutritional assessment of hospitalized children with CP.
Methods: A total of 208 children with CP, aged 1-5 years, who were hospitalized from April to October 2019 were enrolled as subjects. SGNA was used to investigate nutritional status, and the Z-score method recommended by the World Health Organization was used as a reference standard to validate the clinical effectiveness of SGNA.
Results: The detection rate of malnutrition in children with CP was 42.3% by SGNA and 39.4% by the Z-score method (P>0.05). The application of SGNA showed high consistency between different evaluators (κ=0.621, P<0.001). With the Z-score method as the reference standard, SGNA had a sensitivity of 80.5%, a specificity of 82.5%, a positive predictive value of 75.0%, and a negative predictive value of 86.7%, and high consistency was observed between the two evaluation methods (κ=0.622, P<0.001). SGNA was moderately consistent with weight-for-age Z-score and height-for-age Z-score (κ=0.495 and 0.478 respectively, P<0.001) and was poorly consistent with weight-for-height Z-score (κ=0.197, P<0.05).
Conclusions: There is a relatively high incidence rate of malnutrition in children with CP. SGNA can be used as a tool to assess the nutritional status of children with CP.
目的: 了解脑性瘫痪(简称脑瘫)患儿的营养状况，验证主观全面营养评估(SGNA)量表在脑瘫住院患儿营养评估中的临床有效性。
方法: 选取2019年4~10月住院的1~5岁脑瘫患儿208例为研究对象，回顾性收集其SGNA量表评估结果，并以世界卫生组织推荐的Z评分法作为参照标准，验证SGNA量表评估脑瘫患儿营养状况的临床有效性。
结果: SGNA量表和Z评分法对脑瘫患儿的营养不良检出率分别为42.3%、39.4%，差异无统计学意义(P > 0.05)。SGNA量表的应用在不同评估者间呈高度一致性(κ=0.621，P < 0.001)。以Z评分法作为参照标准，SGNA量表的灵敏度、特异度、阳性预测值、阴性预测值分别为80.5%、82.5%、75.0%、86.7%，两种评估方法呈高度一致性(κ=0.622，P < 0.001)。SGNA量表与年龄别体重Z评分、年龄别身高Z评分均呈中度一致性(分别κ=0.495、0.478，P < 0.001)，与身高别体重Z评分一致性低(κ=0.197，P < 0.05)。
结论: 脑瘫患儿营养不良发生率较高；SGNA量表可以作为评估脑瘫患儿营养状况的工具。