老年慢阻肺急性加重期患者营养风险分析及其对预后的影响

Nutritional risk analysis of elderly patients with acute exacerbation of chronic obstructive pulmonary disease and its impact on prognosis

目的探讨老年慢阻肺急性加重期患者的营养风险的影响因素及其对预后的影响。方法选取178例老年慢阻肺急性加重期患者,收集一般资料、生化指标、衰弱状况、对家庭功能的主观满意度,并对患者进行营养风险筛查。结果107例(60.11%)存在营养风险,71例(39.89%)为营养正常。不同营养状况患者的年龄、BMI、肺功能、合并症、慢阻肺急性加重次数的分布比例比较和上臂肌围、总蛋白和白蛋白的值比较,差异有统计学意义(P<0.05)。营养风险与衰弱状况呈正相关性(r=0.719,P<0.05),与家庭关怀度,呈负相关性(r=-0.639,P<0.05)。年龄、肺功能、合并症、慢阻肺急性加重次数、上臂肌围、总蛋白、白蛋白、衰弱状况和家庭关怀度是老年慢阻肺急性加重期患者营养风险的影响因素(P<0.05)。经Kaplan-Meier分析显示,营养正常组的生存时间显著高于营养风险组(χ^(2)=35.262,P<0.05)。结论临床上应对老年慢阻肺急性加重期患者加强营养筛查、监测,采用针对性的干预措施,改善患者的营养状态,从而改善其预后。

Objective To explore the influencing factors of nutritional risk in elderly patients with acute exacerbation of chronic obstructive pulmonary disease and its influence on prognosis.Methods 178 elderly patients with AECOPD were selected to collect general information,biochemical indexes,weakness status,subjective satisfaction with family function,and nutritional risk screening was carried out.Results 107(60.11%)had nutritional risk and 71(39.89%)were in normal nutritional status.There were statistically significant differences in age,BMI,lung function,complications,distribution ratio of AECOPD,and upper arm muscle circumference,total protein and albumin among elderly patients with AECOPD at different nutritional risks(P<0.05).There was a positive correlation between nutritional risk and weakness in elderly patients with AECOPD(r=0.719,P<0.05),and a negative correlation between nutritional risk and family care(r=-0.639,P<0.05).Age,pulmonary function,complications,times of AECOPD,upper arm muscle circumference,total protein,albumin,weakness and family care were the influencing factors of nutritional risk in elderly patients with AECOPD(P<0.05).Kaplan Meier analysis showed that the survival time of the normal nutritional group was significantly higher than that of the nutritional risk group(χ^(2)=35.262,P<0.05).Conclusion Nutrition screening and monitoring should be strengthened in elderly patients with AECOPD,and targeted intervention measures should be adopted to improve the nutritional status of patients,so as to improve their prognosis.