呼吸系统疾病住院患者的营养状况及影响因素

Nutritional status in hospitalized patients with respiratory diseases and its influencing factors

[目的 探讨呼吸系统疾病住院患者的营养状况及其影响因素。方法 选取102例呼吸系统疾病住院患者为研究对象,采用营养风险筛查2002(NRS 2002)和体质量指数(BMI)判断患者的营养风险和营养不良发生情况、并将患者分为危险组[NRS 2002总分≥3分或(和) BMI<18.5 kg/m^(2)]与无危险组(NRS2002总分<3分且BMI≥18.5 kg/m^(2)),收集2组患者的一般临床资料[年龄、性别、体质量及其变化、身高、饮食量变化、入院诊断、住院时间(LOS)等],记录血清白蛋白(ALB)、C-反应蛋白(CRP)]及BMI,采用logistic回归分析营养风险或(和)不良发生的影响因素;按NRS2002评分将患者分为NRS2002<3分组和NRS2002≥3分组,比较2组患者ALB的差异,并采用Spearman分析CRP、ALB与营养风险的相关性。结果 呼吸系统疾病住院患者入院时营养风险发生率34.3%,营养不良发生率为13.7%;年龄≥65岁、入院前1周饮食减少、体质量下降及BMI<18.5 kg/m^(2)是影响呼吸系统疾病住院患者发生营养风险或(和)营养不良的独立危险因素;NRS2002<3分组患者血清ALB高于NRS2002≥3分组患者(P<0.01);单因素回归分析表明,营养风险增加、ALB水平降低(OR=0.705,95%CI为0.527~0.943,P<0.05)。结论 呼吸系统疾病住院患者营养风险或(和)营养不良发生率较高,应重视对这类患者营养筛查和营养干预。

Objective To investigate the nutritional status and influencing factors of hospitalized patients with respiratory diseases.Methods A total of 102 inpatients were selected as participants.The nutritional risk and incidence of malnutrition in patients were determined by nutritional risk screening 2002(NRS 2002)and body mass index(BMI),based on which the patients were then divided into two groups:the risk group(NRS 2002 score≥3 and/or BMI<18.5 kg/m 2),and the no-risk group(NRS 2002 score<3 and BMI≥18.5 kg/m 2).General clinical data[age,gender,body mass and its changes,height,dietary changes,admission diagnosis,length of stay(LOS),etc.],laboratory indicators[serum albumin(ALB),C-reactive protein(CRP)]of the two groups were collected,and BMI was calculated.The influencing factors of nutritional risk or/and malnutrition were analyzed by logistics regression.The patients were further divided into NRS2002<3 group and NRS2002≥3 group,and the differences in ALB between the two groups were compared;correlation between CRP,ALB,and nutritional risk between the two groups was analyzed by Spearman correlation.Results The incidence of nutritional risk and malnutrition among hospitalized patients with respiratory diseases at admission was 34.3%and 13.7%,respectively.Age 65 and above,decreased diet in the week before admission,weight loss and BMI<18.5 kg/m 2 were independent risk factors for nutritional risk or/and malnutrition in hospitalized patients with respiratory diseases.In addition,ALB in NRS2002<3 group was higher than that in NRS2002≥3 group(P<0.01).Single-factor regression analysis showed an increase in nutritional risk and a decrease in ALB levels(OR=0.705,95%CI was 0.527-0.943,P<0.05).Conclusion Hospitalized patients with respiratory diseases have high incidence of nutritional risk or/and malnutrition,and attention should be paid to nutritional screening and intervention for such patients.