侵袭性肺真菌病营养相关性检验指标的临床意义及因子分析

Clinical meaning of nutrition related laboratory indexes for invasive pulmonary mycosis and factor analysis

目的在因子分析基础上,探讨侵袭性肺真菌病(IPM)营养状态评估敏感性检验指标对患者营养状态综合评估的临床意义,以初步明确临床易用性检验指标。方法选取2013年7月至2015年6月在成都大学附属医院住院的IPM患者27例,收集患者的年龄、性别、病程、合并的基础疾病等一般资料及临床资料,以及营养学相关指标[血红蛋白(Hb)、血细胞比容(Hct)、总蛋白(TP)、清蛋白(Alb)、前清蛋白(PA)、血总胆固醇(CHO)、血肌酐(SCr)等],应用主因子分析提取综合预测因子,并计算各检验指标对IPM患者营养状态评估的相对重要性。结果各因子贡献率分别为:λ_1=40.749%、λ_2=21.216%、λ_3=14.823%、λ_4=10.098%、λ_5=6.195%、λ_6=3.978%、λ_7=2.941%。IPM患者营养学指标前4个因子累积贡献率为86.886%,被确定为重要因子纳入分析;各临床营养学相关检验指标相对重要性得分为:Hb(0.140)、Hct(0.247)、TP(0.167)、Alb(0.179)、SCr(0.031)、CHO(0.159)、PA(0.079)。结论 Hb、Hct、TP、Alb、CHO可作为IPM患者营养状态评估的临床易用性指标,在临床患者营养状态评估中引起重视;因子分析可有效用于肺真菌病患者营养状态敏感性检验指标的临床意义分析。

Objective To investigate the clinical significance of sensitive laboratory indexes in the nutritional status as-sessment on the nutritional status comprehensive evaluation in the patients with invasive pulmonary mycosis（IPM）in order to preliminarily definite the clinical easy-to-use laboratory indexes on the basis of factor analysis. Methods Twenty-seven inpatients with IPM in our hospital from July 2013 to June 2015 were selected and the general data and clinical data of the age,sex,disease course and concomitant basic diseases were collected,as well as the nutrition related indexes of hematoglobin（Hb）,hematocrit（Hct）,total protein（TP）,albumin（Alb）,prealbumin（PA）,total cholesterol（GHO）,serum creatinine（SCr）,etc. were also collected. The principal factor analysis was used to extract the comprehensive predictive factor and calculate the relative importance of these factors for the nutritional status assessment in the patients with IPM. Results The contribution rate of each components：λ_1=40.749%,λ_2=21.216%,λ_3=14.823%,λ_4=10.098%,λ_5=6.195%,λ_6=3.978%,λ_7=2.941%,the accumulated contribution rates of the top four principal components were 86.886% and were determined as the important factors for bringing into the analysis. The relative importance scores of each nutrition related laboratory indexes were Hb（0.140）,Hct（0.247）,TP（0.167）,Alb（0.179）,SCr（0.031）,CHO（0.159） and PA（0.079）. Conclusion Hb,Hct,TP,Alb and CHO can serve as the clinical easy-to-use indexes for the nutritional status evaluation in the IPM patients and arouse the attention in the nutritional status evaluation for the clinical pa-tients;the factor analysis can be effectively used in the clinical significance analysis in the nutritional status sensitive laboratory indexes for the IPM patients.