视频荧光透视下的气道侵入与非神经性吞咽困难成人短期营养恶化相关：一项前瞻性研究
Airway invasion on videofluoroscopy is associated with short-term nutritional worsening in adults with non-neurologic dysphagia: a prospective study.
文献信息
| PMID | 42770342 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Eun Chae Lee |
| 作者单位 | Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Daegu, Korea. |
| 期刊 | Journal of Yeungnam medical science |
| SCI 分区 | Q2 |
| IF | 2 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 本研究评估了基线视频荧光透视吞咽研究（VFSS）的发现是否与吞咽困难患者3个月随访时的营养状况相关。
方法： 这项单中心前瞻性观察性研究纳入了2023年4月至2024年3月期间接受VFSS的非神经性吞咽困难成年患者。比较了基线VFSS参数，包括穿透-误吸量表（PAS）、残留测量和功能性吞咽困难量表（FDS）。在基线和3个月时使用微型营养评估简表（MNA-SF）评估营养状况。进行多变量线性回归分析，以评估基线VFSS参数与营养状况变化（ΔMNA-SF）之间的关联，并调整年龄、性别、Charlson合并症指数、基线MNA-SF和基线功能性经口摄入量表（FOIS）。
结果： 54名患者中，44名被纳入最终分析。在调整基线MNA-SF和临床协变量后，较高的PAS评分与营养状况的更大下降显著相关（B=-0.423，p=0.009）。在进一步调整基线FOIS后，这种关联仍然显著（B=-0.428，p=0.012）。PAS类别也显示与ΔMNA-SF显著相关。在评估的预测因子中，PAS在嵌套模型中表现出最高的解释力，而残留测量、FDS和基线FOIS与营养下降无显著关联。
结论： VFSS上气道侵入的严重程度与非神经性吞咽困难患者随后的营养下降独立相关，超出了基线功能性经口摄入的影响。基于VFSS的吞咽安全性评估可能有助于识别有营养恶化风险的患者，并支持早期营养干预。
英文摘要
BACKGROUND: This study evaluated whether findings of a baseline videofluoroscopic swallowing study (VFSS) were associated with nutritional status at a 3-month follow-up in patients with dysphagia.
METHODS: This single-center prospective observational study included adult patients with non-neurologic dysphagia who underwent VFSS between April 2023 and March 2024. Baseline VFSS parameters, including the penetration-aspiration scale (PAS), residue measures, and functional dysphagia scale (FDS), were compared. Nutritional status was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF) at baseline and 3 months. Multivariable linear regression analyses were performed to evaluate the association between baseline VFSS parameters and change in nutritional status (ΔMNA-SF), adjusting for age, sex, Charlson Comorbidity Index, baseline MNA-SF, and baseline functional oral intake scale (FOIS).
RESULTS: Of 54 patients, 44 were included in the final analysis. Higher PAS scores were significantly associated with a greater decline in nutritional status (B=-0.423, p=0.009) after adjusting for baseline MNA-SF and clinical covariates. This association remained significant after further adjustment for baseline FOIS (B=-0.428, p=0.012). PAS category also showed a significant association with ΔMNA-SF. Among the evaluated predictors, PAS demonstrated the highest explanatory power across the nested models, whereas residue measures, FDS, and baseline FOIS were not significantly associated with nutritional decline.
CONCLUSION: The severity of airway invasion on a VFSS is independently associated with subsequent nutritional decline in patients with non-neurologic dysphagia beyond the effect of baseline functional oral intake. A VFSS-based assessment of swallowing safety may help to identify patients at risk of nutritional deterioration and support early nutritional interventions.