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终末期肝病营养支持的研究现状

马红琳 杨婧 金秋 罗润 冷娇 王霞

引用本文:
Citation:

终末期肝病营养支持的研究现状

DOI: 10.3969/j.issn.1001-5256.2022.01.038
利益冲突声明:所有作者均声明不存在利益冲突。
作者贡献声明:马红琳负责文章设计并撰写论文;金秋、罗润、冷娇、王霞参与查阅并整理分析文献;杨婧负责指导撰写及修改论文。
详细信息
    通信作者:

    杨婧,yangjing_dl@163.com

Current status of research on nutritional support in end-stage liver disease

  • 摘要: 营养不良在终末期肝病患者中发生率较高,常促进疾病的进展,对患者的预后产生不良影响。简述了终末期肝病营养不良的病因,重点介绍了终末期肝病营养筛查、评定及治疗的国内外研究进展。希望能对我国终末期肝病患者的营养支持提供启示。

     

  • 表  1  营养筛查工具的评估内容

    项目 RFH-NPT LDUST NRS-2002 GMS MNA-SF
    急性酒精性肝病
    管饲营养
    体液潴留
    BMI
    体质量变化
    饮食情况
    活动状况
    脂肪和肌肉丢失
    疾病状况
    疾病严重情况
    年龄
    精神疾病
    下载: 导出CSV
  • [1] BUNCHORNTAVAKUL C, REDDY KR. Review article: Malnutrition/sarcopenia and frailty in patients with cirrhosis[J]. Aliment Pharmacol Ther, 2020, 51(1): 64-77. DOI: 10.1111/apt.15571.
    [2] NISHIKAWA H, ENOMOTO H, NISHIGUCHI S, et al. Sarcopenic obesity in liver cirrhosis: Possible mechanism and clinical impact[J]. Int J Mol Sci, 2021, 22(4): 1917. DOI: 10.3390/ijms22041917.
    [3] CHAPMAN B, SINCLAIR M, GOW PJ, et al. Malnutrition in cirrhosis: More food for thought[J]. World J Hepatol, 2020, 12(11): 883-896. DOI: 10.4254/wjh.v12.i11.883.
    [4] GRVNGREIFF K, REINHOLD D, WEDEMEYER H. The role of zinc in liver cirrhosis[J]. Ann Hepatol, 2016, 15(1): 7-16. DOI: 10.5604/16652681.1184191.
    [5] KHAN MA, DAR HA, BABA MA, et al. Impact of vitamin d status in chronic liver disease[J]. J Clin Exp Hepatol, 2019, 9(5): 574-580. DOI: 10.1016/j.jceh.2019.03.001.
    [6] LEE WG, WELLS CI, MCCALL JL, et al. Prevalence of diabetes in liver cirrhosis: A systematic review and meta-analysis[J]. Diabetes Metab Res Rev, 2019, 35(6): e3157. DOI: 10.1002/dmrr.3157.
    [7] MVLLER MJ, LAUTZ HU, PLOGMANN B, et al. Energy expenditure and substrate oxidation in patients with cirrhosis: The impact of cause, clinical staging and nutritional state[J]. Hepatology, 1992, 15(5): 782-794. DOI: 10.1002/hep.1840150507.
    [8] European Association for the Study of the Liver. EASL Clinical Practice Guidelines on nutrition in chronic liver disease[J]. J Hepatol, 2019, 70(1): 172-193. DOI: 10.1016/j.jhep.2018.06.024.
    [9] Chinese Society of Hepatology, Chinese Medical Association, Chinese Society of Gastroenterology, Chinese Medical Association. Clinical guidelines on nutrition in end-stage liver disease[J]. J Clin Hepatol, 2019, 35(6): 1222-1230. DOI: 10.3969/j.issn.1001-5256.2019.06.010.

    中华医学会肝病学分会, 中华医学会消化病学分会. 终末期肝病临床营养指南[J]. 临床肝胆病杂志, 2019, 35(6): 1222-1230. DOI: 10.3969/j.issn.1001-5256.2019.06.010.
    [10] BORHOFEN SM, GERNER C, LEHMANN J, et al. The royal free hospital-nutritional prioritizing tool is an independent predictor of deterioration of liver function and survival in cirrhosis[J]. Dig Dis Sci, 2016, 61(6): 1735-1743. DOI: 10.1007/s10620-015-4015-z.
    [11] GEORGIOU A, PAPATHEODORIDIS GV, ALEXOPOULOU A, et al. Evaluation of the effectiveness of eight screening tools in detecting risk of malnutrition in cirrhotic patients: The KIRRHOS study[J]. Br J Nutr, 2019, 122(12): 1368-1376. DOI: 10.1017/S0007114519002277.
    [12] BOULHOSA R, LOURENÇO RP, CÖRTES DM, et al. Comparison between criteria for diagnosing malnutrition in patients with advanced chronic liver disease: GLIM group proposal versus different nutritional screening tools[J]. J Hum Nutr Diet, 2020, 33(6): 862-868. DOI: 10.1111/jhn.12759.
    [13] WU Y, ZHU Y, FENG Y, et al. Royal free hospital-nutritional prioritizing tool improves the prediction of malnutrition risk outcomes in liver cirrhosis patients compared with Nutritional Risk Screening 2002[J]. Br J Nutr, 2020, 124(12): 1293-1302. DOI: 10.1017/S0007114520002366.
    [14] XIAO HJ, YE Q, QI YM, et al. Comparison of RFH-NPT and NRS2002 for nutritional risk screening in liver cirrhosis inpatients[J]. Acta Nutrimenta Sinica, 2019, 41(3): 257-260, 264. DOI: 10.3969/j.issn.0512-7955.2019.03.011.

    肖慧娟, 叶青, 齐玉梅, 等. RFH-NPT与NRS2002在肝硬化住院患者营养风险筛查中的比较研究[J]. 营养学报, 2019, 41(3): 257-260, 264. DOI: 10.3969/j.issn.0512-7955.2019.03.011.
    [15] TIAN YD, ZHANG Y, LI R, et al. Value of different nutritional screening tools on evaluating nutritional status of patients with liver disease[J/CD]. Chin J Liver Dis(Electronic Edition), 2019, 11(3): 52-57. DOI: 10.3969/j.issn.1674-7380.2019.03.010.

    田银娣, 张媛, 李茹, 等. 不同营养筛查工具评估肝病患者营养状况的价值[J/CD]. 中国肝脏病杂志(电子版), 2019, 11(3): 52-57. DOI: 10.3969/j.issn.1674-7380.2019.03.010.
    [16] BOOI AN, MENENDEZ J, NORTON HJ, et al. Validation of a screening tool to identify undernutrition in ambulatory patients with liver cirrhosis[J]. Nutr Clin Pract, 2015, 30(5): 683-689. DOI: 10.1177/0884533615587537.
    [17] MCFARLANE M, HAMMOND C, ROPER T, et al. Comparing assessment tools for detecting undernutrition in patients with liver cirrhosis[J]. Clin Nutr ESPEN, 2018, 23: 156-161. DOI: 10.1016/j.clnesp.2017.10.009.
    [18] SHI SY, HAN JJ, YAN M, et al. Nutritional risk assessment in patients with chronic liver disease[J]. Chin J Hepatol, 2014, 22(7): 536-539. DOI: 10.3760/cma.j.issn.1007-3418.2014.07.012.

    时淑云, 韩军军, 闫茗, 等. 慢性肝病患者的营养风险评估[J]. 中华肝脏病杂志, 2014, 22(7): 536-539. DOI: 10.3760/cma.j.issn.1007-3418.2014.07.012.
    [19] TRAUB J, BERGHEIM I, HORVATH A, et al. Validation of malnutrition screening tools in liver cirrhosis[J]. Nutrients, 2020, 12(5): 1306. DOI: 10.3390/nu12051306.
    [20] LIMA E, ALMEIDA BL, GOMES HB, et al. Agreement between Graz Malnutrition Screening (GMS) with subjective nutritional assessment instruments in hospitalized patients[J]. Nutr Hosp, 2018, 35(5): 1138-1144. DOI: 10.20960/nh.1853.
    [21] CASAS DEZA D, BETORÉ GLARIA ME, SANZ-PARÍS A, et al. Mini nutritional assessment - short form is a useful malnutrition screening tool in patients with liver cirrhosis, using the global leadership initiative for malnutrition criteria as the gold standard[J]. Nutr Clin Pract, 2021, 36(5): 1003-1010. DOI: 10.1002/ncp.10640.
    [22] MARR KJ, SHAHEEN AA, LAM L, et al. Nutritional status and the performance of multiple bedside tools for nutrition assessment among patients waiting for liver transplantation: A Canadian experience[J]. Clin Nutr ESPEN, 2017, 17: 68-74. DOI: 10.1016/j.clnesp.2016.10.003.
    [23] NUNES G, SANTOS CA, BAROSA R, et al. Outcome and nutritional assessment of chronic liver disease patients using anthropometry and subjective global assessment[J]. Arq Gastroenterol, 2017, 54(3): 225-231. DOI: 10.1590/S0004-2803.201700000-28.
    [24] KAPPUS MR, WEGERMANN K, BOZDOGAN E, et al. Use of skeletal muscle index as a predictor of wait-list mortality in patients with end-stage liver disease[J]. Liver Transpl, 2020, 26(9): 1090-1099. DOI: 10.1002/lt.25802.
    [25] MORIWAKI EI, ENOMOTO H, SAITO M, et al. The anthropometric assessment with the bioimpedance method is associated with the prognosis of cirrhotic patients[J]. In Vivo, 2020, 34(2): 687-693. DOI: 10.21873/invivo.11825.
    [26] ESPIRITO SANTO SILVA DD, WAITZBERG DL, PASSOS DE JESUS R, et al. Phase angle as a marker for sarcopenia in cirrhosis[J]. Clin Nutr ESPEN, 2019, 32: 56-60. DOI: 10.1016/j.clnesp.2019.05.003.
    [27] RUIZ-MARGÁIN A, XIE JJ, ROMÁN-CALLEJA BM, et al. Phase angle from bioelectrical impedance for the assessment of sarcopenia in cirrhosis with or without ascites[J]. Clin Gastroenterol Hepatol, 2021, 19(9): 1941-1949. e2. DOI: 10.1016/j.cgh.2020.08.066.
    [28] CIOCÎRLAN M, CAZAN AR, BARBU M, et al. Subjective global assessment and handgrip strength as predictive factors in patients with liver cirrhosis[J]. Gastroenterol Res Pract, 2017, 2017: 8348390. DOI: 10.1155/2017/8348390.
    [29] MOCTEZUMA-VELAZQUEZ C, EBADI M, BHANJI RA, et al. Limited performance of subjective global assessment compared to computed tomography-determined sarcopenia in predicting adverse clinical outcomes in patients with cirrhosis[J]. Clin Nutr, 2019, 38(6): 2696-2703. DOI: 10.1016/j.clnu.2018.11.024.
    [30] KALAFATELI M, MANTZOUKIS K, CHOI YAU Y, et al. Malnutrition and sarcopenia predict post-liver transplantation outcomes independently of the Model for End-stage Liver Disease score[J]. J Cachexia Sarcopenia Muscle, 2017, 8(1): 113-121. DOI: 10.1002/jcsm.12095.
    [31] HOU W, JIANG ZM, YANG J, et al. Consensus on the clinical nutritional intervention for patients with chronic liver diseases[J]. J Clin Hepatol, 2017, 33(7): 1236-1245. DOI: 10.3969/j.issn.1001-5256.2017.07.006.

    侯维, 蒋朱明, 杨剑, 等. 慢性肝病患者肠外肠内营养支持与膳食干预专家共识[J]. 临床肝胆病杂志, 2017, 33(7): 1236-1245. DOI: 10.3969/j.issn.1001-5256.2017.07.006.
    [32] PLAUTH M, BERNAL W, DASARATHY S, et al. ESPEN guideline on clinical nutrition in liver disease[J]. Clin Nutr, 2019, 38(2): 485-521. DOI: 10.1016/j.clnu.2018.12.022.
    [33] ZHU B, ZOU CC, ZHENG X. Malnutrition assessment and nutrition support therapy for end-stage liver disease[J]. J Clin Hepatol, 2017, 33(9): 1699-1706. DOI: 10.3969/j.issn.1001-5256.2017.09.014.

    朱彬, 邹聪聪, 郑昕. 终末期肝病的营养不良评价体系和营养支持治疗[J]. 临床肝胆病杂志, 2017, 33(9): 1699-1706. DOI: 10.3969/j.issn.1001-5256.2017.09.014.
    [34] CAMPION D, GIOVO I, PONZO P, et al. Dietary approach and gut microbiota modulation for chronic hepatic encephalopathy in cirrhosis[J]. World J Hepatol, 2019, 11(6): 489-512. DOI: 10.4254/wjh.v11.i6.489.
    [35] LIU J, QIAO XY, SHI L, et al. Quality evaluation and comparative interpretation of guidelines on nutrition in liver disease from 2017 to 2019[J]. Chin J Evid-based Med, 2020, 20(9): 1083-1091. DOI: 10.7507/1672-2531.201907044.

    刘婧, 乔馨瑶, 石磊, 等. 2017~2019年肝病营养指南的质量评价及对比解读[J]. 中国循证医学杂志, 2020, 20(9): 1083-1091. DOI: 10.7507/1672-2531.201907044.
    [36] IQBAL U, JADEJA RN, KHARA HS, et al. A comprehensive review evaluating the impact of protein source (vegetarian vs. meat based) in hepatic encephalopathy[J]. Nutrients, 2021, 13(2): 370. DOI: 10.3390/nu13020370.
    [37] BUTTERWORTH RF. Beneficial effects of L-ornithine L-aspartate for prevention of overt hepatic encephalopathy in patients with cirrhosis: A systematic review with meta-analysis[J]. Metab Brain Dis, 2020, 35(1): 75-81. DOI: 10.1007/s11011-019-00463-8.
    [38] BUTTERWORTH RF, MCPHAIL M. L-Ornithine L-Aspartate (LOLA) for hepatic encephalopathy in cirrhosis: Results of randomized controlled trials and meta-analyses[J]. Drugs, 2019, 79(Suppl 1): 31-37. DOI: 10.1007/s40265-018-1024-1.
    [39] KOOP AH, MOUSA OY, PHAM LE, et al. An argument for vitamin D, A, and zinc monitoring in cirrhosis[J]. Ann Hepatol, 2018, 17(6): 920-932. DOI: 10.5604/01.3001.0012.7192.
    [40] CHEN T, ZUO X, WANG S, et al. The effect of vitamin D supplementation on the progression of fibrosis in patients with chronic liver disease: A protocol for a systematic review and meta-analysis[J]. Medicine (Baltimore), 2020, 99(19): e20296. DOI: 10.1097/MD.0000000000020296.
    [41] MOSZAK M, SZULIŃSKA M, WALCZAK-GAȽĘZEWSKA M, et al. Nutritional approach targeting gut microbiota in NAFLD-to date[J]. Int J Environ Res Public Health, 2021, 18(4). DOI: 10.3390/ijerph18041616.
    [42] CAO Q, YU CB, YANG SG, et al. Effect of probiotic treatment on cirrhotic patients with minimal hepatic encephalopathy: A meta-analysis[J]. Hepatobiliary Pancreat Dis Int, 2018, 17(1): 9-16. DOI: 10.1016/j.hbpd.2018.01.005.
    [43] DIETERICH W, SCHUPPAN D, SCHINK M, et al. Influence of low FODMAP and gluten-free diets on disease activity and intestinal microbiota in patients with non-celiac gluten sensitivity[J]. Clin Nutr, 2019, 38(2): 697-707. DOI: 10.1016/j.clnu.2018.03.017.
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  • 收稿日期:  2021-05-05
  • 录用日期:  2021-06-22
  • 出版日期:  2022-01-20
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