65例老年肺结核合并糖尿病患者的营养状况评价

Analysis on nutrition status in 65 elderly patients with pulmonary tuberculosis and diabetes

目的通过对老年肺结核合并糖尿病患者的营养状况调查和分析,提出合理化营养支持建议。方法设老年肺结核合并糖尿病患者组(A组)、单纯老年肺结核患者组(B组)和正常老年人组(C组),各65例(名),选择体质指数(BMI)、血红蛋白(Hb)、总淋巴细胞(TLC)、血清白蛋白(Alb)、肌酐-身高指数5项营养指标进行对比分析。两样本间均数差异统计学检验采用t检验,营养不良率差异统计学检验采用χ2检验,P<0.05为有统计学意义。结果 (1)A组、B组与C组5种营养指标(BMI、Hb、TLC、Alb、肌酐-身高指数)分别是:A组分别为(18.09±1.88)、(119.30±13.51)g/L、(1.21±0.39)×109/L、(29.76±4.88)g/L、75.44%±7.23%;B组分别为(18.53±2.05)、(126.31±8.76)g/L、(1.28±0.13)×109/L、(37.44±5.46)g/L、76.53%±8.44%;C组分别为(21.11±2.11)、(132.34±8.84)g/L、(2.93±0.53)×109/L、(43.21±7.54)g/L、86.09%±6.75%。A组、B组与C组相比差异均有统计学意义(tAC值分别是8.58、6.77、6.76、12.03、8.66;tBC值分别是7.05、3.89、20.98、4.98、5.28。P值均<0.01);A组与B组Hb、Alb差异有统计学意义(t值分别为3.51、8.43,P值均<0.01)。(2)营养不良率比较:A组分别为44.6%、52.3%、80.0%、64.6%、46.2%。B组不良率分别为38.5%、49.2%、76.9%、46.2%、41.5%。C组不良率分别为6.2%、6.2%、0%、4.6%、7.7%。A、B两组各项指标所得营养不良率均高于C组,有统计学意义(χ2AC值分别是23.4、31.3、79.7、44.0、24.4;χ2BC值分别是17.8、28.0、74.3、27.5、20.1。P值均<0.01)。结论老年肺结核合并糖尿病患者营养不良的发生率较高,故老年肺结核合并糖尿病患者更应注重膳食平衡。

Objective To study the nutrition status of elderly patients with pulmonary tuberculosis（PTB） and diabetes mellitus（DM） and explore the nutrition improvement advice for them.Methods All patients were assigned to 3 groups： elderly PTB and DM as group A（n=65）,elderly PTB as group B（n=65）,and elderly normal public group as group C（n=65）.Five parameters were chosen to analyze the nutrition status,including body mass index（BMI）,hemoglobin（Hb）,total lymphocyte count（TLC） of PBMC,serum albumin（Alb）,and creatinine-height index using t-test and χ2 test.Results（1） These five parameters（BMI,Hb,TLC,Alb,and creatinine-height index） were measured in three groups： x±s of the five parameters were（18.09±1.88）,（119.30±13.51） g/L,（1.21±0.39）×109/L,（29.76±4.88） g/L,and 75.44%±7.23% in group A,respectively;x±s were 18.53±2.05,（126.31±8.76） g/L,（1.28±0.13）×109/L,（37.44±5.46） g/L,and 76.53%±8.44% in group B,respectively;x±s were（21.11±2.11）,（132.34±8.84） g/L,（2.93±0.53）×109/L,（43.21±7.54） g/L,and 86.09%±6.75% in group C,respectively.Significant differences were found in these five parameters in the elderly PTB with DM group and elderly normal public group,also seen in elderly PTB group and elderly normal public group（tAC=8.58,6.77,6.76,12.03,8.66,respectively;tBC=7.05,3.89,20.98,4.98,5.28,respectively,all P0.01）.The incidence of malnutrition according to HB,Alb of the elderly PTB with DM group was higher than that in the elderly PTB group（t=3.51,8.43 respectively,all P0.01）.（2） The incidence of malnutrition according of group A was 44.6%,52.3%,80.0%,64.6%,46.2%,respectively;the incidence of malnutrition according of group B was 38.5%,49.2%,76.9%,46.2%,41.5%,respectively;and the incidence of malnutrition according of group C was 6.2%,6.2%,0%,4.6%,7.7%,respectively.The incidence of malnutrition in group A and B were both higher than that in group C（χ2AC=23.4,31.3,79.7,44.0,24.4,respectively;χ2BC=17.8,28.0,74.3,27.5,20.1,respectively,all P0.01）.Conclusion The incidence of malnutrition is higher in the patients of the elderly PTB with DM and these patients should balance their food choices.