老年慢性阻塞性肺疾病患者入院营养标志物与压力性损伤的相关性研究

Correlations between admission nutritional markers and pressure injury in elderly patients with chronic obstructive pulmonary disease

目的探讨老年慢性阻塞性肺疾病(慢阻肺)患者营养标志物与压力性损伤(pressure injury,PI)的相关性。方法纳入2020年1月-2021年12月入住四川大学华西医院及都江堰市人民医院老年病科的慢阻肺合并PI的老年患者行回顾性分析,收集营养标志物指标等血液指标,分别与PI危险因素指标Braden评分、PI严重程度指标PI分期进行相关性分析。结果共纳入慢阻肺合并PI患者293例。不同Braden评分组患者白蛋白、前白蛋白差异有统计学意义(P<0.05),Braden评分分值与白蛋白(rs=0.241,P<0.001)、前白蛋白(rs=0.179,P=0.002)、血红蛋白(rs=0.199,P=0.001)呈正相关;不同PI分期患者白蛋白、球蛋白、红细胞计数、血钠、血氯、C反应蛋白差异有统计学意义(P<0.05),PI分期与白蛋白呈负相关(rs=-0.192,P=0.001),与血钠(rs=0.139,P<0.001)、血氯(rs=0.184,P<0.001)、C反应蛋白(rs=0.177,P=0.020)呈正相关。结论对老年慢阻肺患者行PI风险评估及严重程度评定时,要加强对营养标志物的关注,评估患者是否存在蛋白质营养不良风险,有助于提高PI风险评估及严重程度预测的准确性,有效提高PI的防治效果。

Objective To explore the correlations between nutritional markers and pressure injury(PI)in elderly patients with chronic obstructive pulmonary disease(COPD).Methods Retrospective analysis was conducted on elderly patients with COPD and PI who were admitted to the geriatric department of West China Hospital of Sichuan University or Dujiangyan People’s Hospital between January 2020 and December 2021.The blood biochemical indicators mainly including nutritional markers were collected,and their correlations with PI risk factor index Braden score and PI severity index PI stage were analyzed.Results A total of 293 patients with COPD and PI were included Among the five Braden score groups,the differences in the levels of albumin and prealbumin were statistically significant(P<0.05),and the Braden score was positively correlated with albumin(rs=0.241,P<0.001),prealbumin(rs=0.179,P=0.002),and hemoglobin(rs=0.199,P=0.001).Among the six PI stage groups,the differences in the levels of albumin globulin,red blood cell count,serum sodium,blood chloride and C-reactive protein were statistically significant(P<0.05)and the PI stage was negatively correlated with albumin(rs=-0.192,P=0.001),and positively correlated with serum sodium(rs=0.139,P<0.001),blood chloride(rs=0.184,P<0.001),and C-reactive protein(rs=0.177,P=0.020).Conclusion When PI risk assessment and severity assessment are performed on elderly COPD patients,it is necessary to pay more attention to nutritional markers and assess whether the patients are at risk of protein malnutrition,which will help to improve the accuracy of PI risk assessment and severity prediction,and effectively improve the efficacy of PI prevention and treatment.