重视营养不良对慢性肢体威胁性缺血的影响

More attention should be paid to the influence of malnutrition on chronic limb threatening ischemia

慢性肢体威胁性缺血(CLTI)是周围血管疾病最严重阶段,截肢率和病死率较高。疼痛、感染可引起CLTI患者营养物质摄入不足和蛋白丢失,患者的营养不良发生率较高。越来越多的研究结果表明,营养不良会增加截肢、死亡风险,延迟创面的愈合时间,是CLTI患者接受血运重建后截肢及死亡风险的独立危险因素。营养筛查工具如老年营养风险指数、微型营养评价、营养控制状态等可帮助筛查出有营养风险的CLTI患者,对其进行营养干预可以改善预后。

Chronic limb threatening ischemia(CLTI)is a severe condition of peripheral artery disease with high amputation and mortality.Pain and infection cause insufficient nutrient intake and protein loss in CLTI patients,while malnutrition is very prevalent in patients with CLTI and associated with poor prognosis.More and more studies have shown that malnutrition increases the risk of amputation and mortality,delays the time of wound healing.Moderate and severe malnutrition are independent risk factors for amputation and mortality in CLTI patients undergoing surgical or endovascular revascularization.Nutritional screening tools such as Geriatric nutritional risk index,Mini Nutritional Assessment and Controlling nutritional status can help to stratify patients with nutritional risk.Identification of patients with nutritional risk and nutritional intervention can improve the prognosis of CLTI patients.