老年良性呼吸疾病住院患者营养状态的临床研究

Clinical study of nutritional status in elderly patients with benign respiratory disease

目的观察老年良性呼吸疾病住院患者的营养状态，评估其与临床结局的相关性。方法前瞻性研究2012年4—5月年龄≥65岁的老年良性呼吸疾病住院患者，应用微型营养评定精（MNA-SF）法了解其营养状态，并观察临床结局，分析其相关性。结果本研究纳入符合入选标准患者1269例，平均年龄（74．0±6．5）岁；体质指数（23．3±3．8）kg／m2；利手握力为（16．7±17．2）kg，随增龄下降；上臂围（25．7±3．7）cm，小腿围（32．3±3．8）cm；1224例患者完成了MNA-SF，营养不良145例（11．8％）、营养不良风险411例（33．6％）、营养正常668例（54．6％）；随增龄，营养不良和营养不良风险发生率均增加；其中营养不良者的病死率高、住院时间长和总住院费多（均P〈0．01）。结论老年良性呼吸疾病的住院患者营养不良和营养不良风险发生率较高，可能导致其临床结局恶化，应重视住院期间的营养状况评价。

Objective To investigate the nutritional status in elderly patients with benign respiratory disease and assess the correlation between nutritional status and clinical outcomes. Methods A prospective study of the elderly patients with benign respiratory disease, aged 65 years and over, from April 2012 to May 2012, was conducted. Mini-Nutritional Assessment-Short Form （MNA-SF） was used to assess the nutritional status. Associations between nutritional status and clinical outcomes were analyzed. Results A total of 1269 patients who met inclusion criteria were enrolled in this study, with a mean age of （74. 0±6.5） years, a mean body mass index of（23.3±3, 8） kg/m2 , a mean grip strength of （16.7±17.2） kg, a mean upper arm circumference of（25.7±3.7） cm, a mean calf circumference of （32.3±3.8）cm. The grip strength declined with the increase of age. 1 224 subjects completed the MNA-SF, among whom 145 cases （11.8%） suffered from malnutrition, 411 cases （33.6%） were at a risk of malnutrition, 668 cases （54. 60%） were well nourished. The incidence of malnutrition and the risk of malnutrition were increased with ageing. People with malnutrition had a higher mortality, longer hospital stay and more hospital costs （all P〈0. 01）. Conclusions Elderly patients with benign respiratory disease have a higher prevalence of malnutrition and a higher risk of malnutrition, which may lead to worse clinical outcomes. More attention should be paid to the assessment of nutritional status during hospitalization.