基于营养风险评估的多学科协同个体化营养干预对肝硬化患者营养状况、肝功能及血清肝纤维化指标的短期影响OA

Objective:To evaluate the impact of individualized nutritional intervention by a multidisciplinary team(MDT)based on nutritional risk assessment on short-term(3 months)nutritional status,liver function,and serum liver fibrosis markers in patients with cirrhosis.Methods:A total of 60 patients with cirrhosis admitted to the People's Hospital of Gaoyou Affiliated to Yangzhou University from May 2023 to May 2025 were selected and divided into a control group(conventional nutritional management,n=30)and an intervention group(conventional nutritional management combined with MDT nutritional intervention based on nutritional risk assessment,n=30)using a random number table.Both groups of patients received appropriate nutritional intervention on day 1 of admission.To reduce the impact of fluid fluctuations and acute stress on laboratory indicators in the early stages of admission,blood samples taken in the morning of day 2 of admission and physical measurements were used as the baseline(T0).Follow-up was conducted at 1 month(T1)and 3 months(T2)after discharge.The observed indicators included nutritional status[body mass index(BMI),hemoglobin(Hb),serum albumin(ALB),prealbumin(PA)],liver function[alanine aminotransferase(ALT),prothrombin time(PT),total protein(TP)]and liver fibrosis indicators[collagen Ⅳ(Ⅳ-C),hyaluronic acid(HA),laminin(LN),prothrombin Ⅲ(PCⅢ)]were evaluated on the second day,one month and three months after admission.Mixed linear models were used to analyze the differences and changing trends of each indicator between the two groups at different time points.Results:The examination results of the patients showed that the levels of BMI,Hb,ALB and TP in the intervention group were higher than those in the control group(P<0.05);the levels of ALT,PT,Ⅳ-C,HA,LN and PCⅢ were lower than those in the control group(P<0.05).Mixed linear model analysis showed that the intervention group improved significantly faster than the control group over time in terms of various indicators,but the response magnitudes of different indicators were not completely consistent.The interaction effects between groups and time were significant for TP,ALB,ALT,PT,Ⅳ-C,HA,LN,and PCⅢ(P<0.05).Conclusion:Nutritional intervention based on nutritional risk assessment by MDT can effectively improve the short-term nutritional status,liver function,and serum liver fibrosis markers in patients with cirrhosis.However,the follow-up period of the study was short,and long-term clinical outcomes cannot be inferred at this time.