神经内科老年住院患者营养状况评价及其与并发症的关系研究

Nutritional Evaluation and Its Relationship to Complications in Neurology Senile Inpatients

目的评价神经内科老年住院患者的营养状况并探讨其与并发症的关系。方法选择2012年3—5月我院神经内科老年住院患者(年龄≥65岁)237例为研究对象,采用营养风险筛查(NRS2002)、修订的微型营养评定简表(MNA-SF)对患者的营养状况进行评价,同时测定其人体测量学指标及生化指标,观察其并发症发生情况。结果根据NRS2002评价结果,237例患者中营养正常者88例,营养不良风险者149例,两组患者体质指数(BMI)、上臂围(AC)、小腿围(CC)及清蛋白(ALB)、血红蛋白(Hb)、总淋巴细胞计数(TLC)水平比较,差异均有统计学意义(P<0.05);并发症发生率比较,差异亦有统计学意义(χ2=48.320,P<0.05)。根据MNA-SF评价结果,237例患者中营养正常者88例,营养不良风险者73例,营养不良者76例,3组患者BMI、AC、CC及ALB、Hb、TLC水平比较,差异均有统计学意义(P<0.05);并发症发生率比较,差异亦有统计学意义(χ2=59.650,P<0.05)。Pearson相关分析结果显示,NRS2002与MNA-SF呈负相关(r=-0.863,P<0.01);一致性良好(Kappa=1.0,P<0.01)。结论 NRS2002、MNA-SF均可有效地评价神经内科老年住院患者营养状况,神经内科营养不良风险及营养不良老年患者并发症发生率增高,临床应加以重视。

Objective To evaluate the nutritional status in neurology senile inpatients and investigate its relationship to complications. Methods Nutritional risk screening （ NRS2002 ）, revised Mini Nutritional Assessment （ MNA - SF） were used to evaluate the nutritional status of 237 elderly patients aged ≥ 65 year old hospitalizing in Department of Neurology of this hospital from March to May of 2012. The anthropometric indicators and biochemical parameters were determined simultaneously and complications observed. Results By the results of NRS2002 evaluation, 88 had normal nutritional status, 149 had malnut- ritional risks, there was significant difference in body mass index （BMI）, upper arm circumference （AC）, calf circumference （CC）, and levels of albumin （ ALB）, hemoglobin （ Hb）, total lymphocyte count （TLC） between the two groups （ P 〈 0.05）, and in incidence of complications （x2 = 48. 320, P 〈 0. 05）. By MNA - SF, 88 had normal nutritional status, 73 had malnutritional risks, 76 had malnutrition, there was significant difference in BMI, AC, CC and levels of ALB, Hb, TLC be- tween the three groups （P 〈 0. 05 ）, and in incidence of complications （ X2 = 59. 650, P 〈 0. 05 ）. By Pearson correlation anal- ysis, NRS2002 was negatively correlated with MNA -SF （r = -0. 863, P 〈 0. 01 ）, its consistency was good （Kappa = 1.0, P 〈 0.01 ）. Conclusion NRS2002 and the MNA - SF can both evaluate effectively the nutritional status of elderly patients hos- pitalizing in Department of Neurology. Patients with malnutritional risks or malnutrition have high incidence of complications, which should be paid attention to clinically.