慢性胃炎患者膳食营养状况分析

Nutritional Status and Nutrient Intake in Patients with Chronic Gastritis

目的:探讨慢性胃炎患者的膳食营养状况及膳食模式特点,为预防和控制慢性胃炎提供科学依据。方法:采用横断面研究,于山东某医院内镜室选取427名(18~69岁)完成胃镜检查者,根据胃镜检查报告结果和诊断标准,将研究对象分为慢性非萎缩性胃炎组205名和慢性萎缩性胃炎组222名。收集研究对象的基本信息、相关临床检查指标;采用24h膳食回顾法收集研究对象近期膳食情况,分析两组人群营养素摄入水平及供能来源。根据食物频率表收集研究对象过去约6个月内的食物种类及平均每天的食物消费水平,并累计每位研究对象1周内消费的食物种类来计算DDS,每消费1类食物计1分,两类食物计2分,最高为9分。结果:慢性胃炎低体重率为4.7%,其中慢性萎缩性胃炎组患者低体重率达5.9%,而慢性非萎缩性胃炎组为3.4%,两组间无显著差异(P>0.05)。膳食能量及营养素摄入情况显示,慢性胃炎患者能量、碳水化合物、蛋白质、脂肪摄入量分别为1887kcal/d、268.94g/d、68.33g/d、60.42g/d,其中慢性萎缩性胃炎组能量、碳水化合物和脂肪的摄入水平分别为1940kcal/d、278.77g/d、61.92g/d,显著高于非萎缩性胃炎组(1831kcal/d、258.64g/d、58.85g/d)(P均<0.05);而蛋白质摄入量慢性萎缩性胃炎组人群达到68.42g/d,显著低于非萎缩性胃炎组(72.66g/d)(P<0.05)。膳食食物种类分析,慢性胃炎人群膳食多样化程度为7.22分,其中慢性萎缩性胃炎组的膳食多样化程度为6.96分,显著低于非萎缩性胃炎组的7.52分(P<0.05)。慢性萎缩性胃炎组蔬菜和水果的平均摄入量(275.19、99.53g/d)显著低于非萎缩性胃炎组(303.91、119.99g/d)(P均<0.05)。结论:慢性胃炎患者膳食结构不合理,每周食用的食物种类较少,碳水化合物摄入量较高,而蔬菜和水果摄入量明显不足。其中慢性萎缩性胃炎更为突出,故应加强慢性胃炎人群的营养干预评价,及时有效地改善其营养状况。

Objective To evaluate the dietary nutritional status and dietary patterns of patients with chronic gastritis,and to provide reference for prevention and control of chronic gastritis.Method The cross-sectional study was designed.Totally 427 subjects(18~69 years)who completed the gastroscopy from endoscope room in a hospital in Shandong province,were recruited.According to gastroscopy results and diagnostic criteria,427 subjects were divided into the chronic non-atrophic gastritis group(205 patients)and the chronic atrophic gastritis group(222 patients).The information of physical examination and related indicators of all subjects were collected,such as height,weight,smoking,drinking,and education and so on.Recent dietary consumption status of subjects was collected by 24-hour dietary retrospective method,and nutrient intake level and energy source of the two groups were compared.Analysis dietary types weekly and food consumption levels of the two groups via the food frequency questionnaire(FFQ)over the past(about 6 months),and the dietary diversity score(DDS)of each subject was calculated by accumulating the type of food consumed within 7 days,consumed one type as one point,two types as two points,up to 9 points.Result The low body weight rate of chronic gastritis was 4.7%,the low body weight rate of patients with chronic atrophic gastritis was 5.9%,while that of chronic non-atrophic gastritis group was 3.4%,there was no significant difference between the two groups(P>0.05).Dietary energy and nutrient intake showed that the intake of energy,carbohydrate,protein and fat in patients with chronic gastritis was 1 887kcal/d,268.94g/d,68.33g/d and 60.42g/d,respectively,of which chronic atrophic gastritis group the levels of energy,carbohydrates and fat in the population were 1 940 kcal/d,278.77 g/d and 61.92 g/d,respectively,which were significantly higher than those of the non-atrophic gastritis group of 1 831 kcal/d,258.64 g/d and 58.85 g/d(P<0.05).Protein intake reached 68.42 g/d in the chronic atrophic gastritis group,which was significantly lower than the non-atrophic gastritis group 72.66 g/d(P<0.05).Dietary species analysis showed that the dietary diversification of chronic gastritis was 7.22 points,and the dietary diversity of the chronic atrophic gastritis group was 6.96 points significantly lower than that of the non-atrophic gastritis group(7.52 points)(P<0.05).The average intake of vegetables and fruits in the chronic atrophic gastritis group were 275.19 g/d and 99.53 g/d,which was significantly lower than that of the non-atrophic gastritis group of 303.91 g/d and 119.99 g/d(P<0.05).Conclusion The dietary structure of chronic gastritis patients was unreasonable,less food species per week,higher carbohydrate intake,significantly inadequate vegetables and fruits intake.Among them,the problem of chronic atrophic gastritis is more prominent.It is necessary to strengthen the nutritional monitoring and evaluation of patients with chronic gastritis and improve their nutritional status.