高龄高血压患者营养风险和免疫功能评估

Nutritional risk screening and immunity analysis in elderly inpatients with hypertension

目的分析高龄高血压患者营养风险和免疫功能情况,探讨增龄对营养风险及免疫功能的影响。比较不同营养风险的高龄高血压患者免疫功能及实验室检测指标的差异。方法入组高龄高血压患者135例,非高龄高血压患者146例。所有研究对象进行营养风险筛查(NRS2002),并采用流式细胞术和散射比浊法进行细胞免疫和体液免疫的检测。抽取静脉血行血红蛋白(Hb)、白蛋白(ALB)、前白蛋白(PA)、三酰甘油(TG)、总胆固醇(TC)、超敏C反应蛋白(hs-CRP)的测定。结果高龄高血压患者中具有营养风险者的比例高于非高龄高血压患者(51.85%VS 30.14%,P<0.05)。细胞免疫分析显示高龄高血压老人CD3+、CD3+CD4+、CD3+CD8+细胞比例降低(P <0.05),CD3-CD(16+56)+细胞比例高于非高龄高血压患者(P <0.05)。高龄高血压患者较非高龄高血压患者IgM、B因子水平下降(P<0.05)。与无营养风险的高龄高血压患者相比较,具有营养风险的高龄高血压患者细胞免疫和体液免疫分析差异无统计学意义。具有营养风险的高龄高血压患者Hb、ALB、PA、TG较无营养风险者降低(P <0.05),而hs-CRP高于无营养风险者(P <0.05)。Spearman相关性分析显示营养风险和Hb、ALB、PA、TG呈负相关,与hs-CRP呈正相关(P<0.05)。结论高龄高血压患者营养风险增高,细胞免疫和体液免疫较非高龄高血压患者均出现变化,以细胞免疫功能减退为主。不同营养风险的高龄高血压患者免疫功能差异无统计学意义,营养风险与Hb、ALB、PA、TG、hs-CRP相关。

Objective To investigate the effect of aging on nutritional status and immunity in patients with hypertension,compare the difference of immune function between aged patients with and without nutritional risk,and analyze the correlations between Nutritional Risk Screening 2002(NRS2002)and several biochemical parameters.Methods Totally 135 inpatients with hypertension aged≥80 years were recruited as the elderly group,with 146 hypertensive patients aged<80 years enrolled as the control group.Nutritional risk screening was performed by NRS2002.Cellular immunity and humoral immunity were tested by flow cytometry and scatter turbidimetry,respectively.Hemoglobin(Hb),albumin(ALB),prealbumin(PA),triglyceride(TG),total cholesterol(TC),and high-sensitivity C-reactive protein(hs-CRP)were analyzed in the elderly subjects.Results The proportion of hypertensive patients with nutritional risk in the elderly group was higher than that in the control group(51.85%vs.30.14%,P<0.05).Compared with the control group,the proportions of CD3+,CD3+CD4+and CD3+CD8+cells were significantly lower(P<0.05),but the proportion of CD3-CD16+CD56+cells was significantly higher in the elderly group(P<0.05).The levels of IgM and B factor were also lower in the elderly group(P<0.05).However,there was no significant difference in cellular immunity or humoral immunity between the elderly hypertensive patients with nutritional risk and those without nutritional risk.In addition,Hb,ALB,PA and TG were negatively correlated with nutritional risk,while hs-CRP was positively correlated with nutritional risk(P<0.05).Conclusions In the hypertensive patients of 80 years or older,the nutritional risk is increased,both cellular immunity and humoral immunity are changed,especially cellular immunity is decreased.However,there is no significant difference in immune function among the elderly hypertensive patients with different nutritional risks.Some biochemical parameters,including Hb,ALB,PA,TG and hs-CRP,are correlated with nutritional risk.