心血管内科老年住院病人营养不良和营养风险评估分析

Malnutrition and nutritional risk in senior patiente at the department of cardiology

目的:调查心血管内科老年病人入院时的营养状况,为存在营养不良和有营养风险病人实施及时的营养支持提供参考依据。方法:采用体质指数(BMI)、血清清蛋白(ALB)和前清蛋白(PA)水平等指标进行营养不良评估。采用NRS2002营养风险筛查法,选择入院48 h内、符合NRS2002标准、可获得BMI的病人200例。以BMI<18.5者计3分进行营养风险评分(NRS);对不完全符合NRS2002标准,不能获得BMI的54例病人,以ALB替代,ALB<30 g/L者计3分,来进行营养风险评分。NRS2002≥3分判定有营养风险,统计营养不良和有营养风险的发生率。结果:在符合NRS2002标准的病人中,营养风险发生率为38.0%。符合和不完全符合NRS2002标准的病人共254例,营养风险发生率为38.6%。BMI<18.5、ALB<30 g/L和PA<200 mg/L的病人,营养不良的发生率分别为9.0%、2.8%和29.1%。在BMI≥18.5病人中,NRS评分≥3分者占总调查病人的29%。农村和城市老年病人营养风险发生率分别为48.5%和32.5%,两者有显著性差异(P<0.05)。结论:心血管内科老年病人营养风险的发生率较高,应重视老年病人特别是农村老年病人营养风险的发生。NRS2002方法能预测和及时发现营养不良病人。

Objective： To investigate the nutritional status of senior patients in a Department of Cardiology.Methords： Malnutrition was assessed using body mass index（BMI）,serum albumin（ALB） and prealbumin（PA）levels.Two hundred patients who were up to the standard of Nutritional Risk Screening 2002（NRS2002） were scored after admission.Among the 54 patients who were not entirely up to the standard of NRS2002,those whose ALB were〈30 g/L scored 3 points. Results： The incidence of nutritional risk was 38.0% in 200 patients who were up to the standard of NRS2002 and 38.6% in all patients.The incidences of malnutrition showed by BMI18.5,ALB30 g/L and PA200 mg/L were 9.0%,2.8% and 29.1%,respectively.Among the patients whose BMI was≥18.5,those whose score was≥3 amounted to 29% of all the 200 patients.The incidence of nutritional risk was higher in senior patients from the countrycide（48.5%） than in those from the city（32.5%）（P〈0.05）.Conclousion： The nutritional risk is higher in senior patients from the Department of Cardiology.