山东临沂市老年肺结核患者膳食与营养状况分析

ANALYSIS OF DIETARY AND NUTRITIONAL STATUS OF ELDERLY PULMONARY TUBERCULOSIS PATIENTS IN LINYI CITY, SHANDONG PROVINCE

目的了解老年肺结核患者膳食与营养状况,为有效地改善其营养不良提供科学依据。方法采用病例对照研究,于2013年至2017年在山东省临沂市某医院和四个结核病防治所随机选取60岁以上的1795位老年肺结核患者,并在当地(或同一社区或村组)随机选择1146位正常老年人作为正常对照。收集研究对象的个人基本信息、身高、体重等指标,并计算BMI,进行营养状况评价;采用连续3d24h膳食回顾法对其开展膳食摄入情况调查;计算其能量及各种营养素摄入量。结果老年肺结核组能量、蛋白质、K、Ca、Zn、Se、维生素A、维生素B1、维生素C等营养素的摄入水平未达到中国居民膳食营养素参考摄入量(DRIs)。其中老年肺结核组蛋白质和锌的摄入量为(56.91 g/d和8.43 mg/d)均明显低于正常老年组人群(61.33 g/d和9.05 mg/d),老年肺结核组营养不良率达到27.7%,显著高于健康老年人群(15.6%)。结论老年肺结核患者蛋白质和锌等营养素摄入不足,营养不良较为严重。因此,应加强老年肺结核患者营养监测与评价,及时有效地改善其营养状况。

Objective To investigate the nutritional status and food intake of elderly patients with pulmonary tuberculosis (PTB), so as to provide scientific basis for improving their malnutrition efficiently. Methods A case-control study was conducted in which 1795 elderly patients aged over 60 years with pulmonary tuberculosis were randomly selected in a hospital and four TB control centers in Linyi City, Shandong Province during 2013 to 2017. Meanwhile, 1146 health elderly were selected randomly as normal control in the same community or village group. The basic information such as height, weight was collected and BMI was calculated and evaluated. The 24-hour dietary recall survey for 3 consecutive days was carried out and analyzed for energy and nutrient intakes. Results The intake levels of energy, protein, K, Ca, Zn, Se, vitamin A, vitamin B1, vitamin C and other nutrients in the elderly pulmonary tuberculosis group were lower then Chinese dietary reference intakes (DRIs). The intake was significantly lower for protein (56.91 g/d) and zinc (8.43 mg/d) in the elderly pulmonary tuberculosis patients than that in the normal elderly (61.33 g/d, 9.05 mg/d )(P< 0.05). The rate of malnutrition was significantly higher in elderly pulmonary tuberculosis patients (27.7%), than that in the healthy elderly population (15.6%). Conclusion The protein and zinc intakes are insufficient obviously in elderly patients with PTB. The prevalence of malnutrition is higher in the elderly with pulmonary tuberculosis. Therefore, nutritional surveillance should be needed among the elderly with pulmonary tuberculosis, in order to improve their nutrition status timely and effectively.