老年肝硬化合并糖尿病患者的营养状况及影响因素分析

Analysis of nutritional status and influencing factors in elderly patients with liver cirrhosis and diabetes mellitus

目的观察老年肝硬化合并糖尿病患者的营养状况,并分析发生营养不良的影响因素。方法选取2018年1月至2022年1月该院148例老年肝硬化患者为研究对象,根据是否合并糖尿病分为糖尿病组(n=81)和非糖尿病组(n=67)。采用营养风险筛查2002(NRS-2002)量表对两组患者进行营养风险评估,比较两组患者血清学指标。再根据NRS-2002量表评分将糖尿病组患者分为营养良好组和营养不良组,通过多元logistic回归分析探讨老年肝硬化合并糖尿病患者发生营养不良的影响因素。结果糖尿病组NRS-2002评分≥3分者百分比明显高于非糖尿病组(P<0.05)。糖尿病组前清蛋白(PA)、清蛋白(ALB)、总蛋白(TP)、血清总胆固醇(CHOL)、血红蛋白(Hb)水平低于非糖尿病组,差异有统计学意义(P<0.05)。单因素分析发现,糖尿病营养良好组和营养不良组病程,Child-Pugh分级,肝硬化并发症中自发性腹膜炎、腹水发生情况,居住区域,以及PA、ALB、TP、Hb、血清肌酐(Cr)水平均有明显差异(P<0.05)。多元logistic回归分析发现,病程、Child-Pugh分级、腹水、自发性腹膜炎、ALB水平为老年肝硬化合并糖尿病患者发生营养不良的影响因素。结论老年肝硬化合并糖尿病患者营养不良发生率较高,病程、Child-Pugh分级、腹水、自发性腹膜炎、ALB为其发生营养不良的影响因素。

Objective To investigate the nutritional status of elderly patients with liver cirrhosis and diabetes mellitus,and analyze the influencing factors of malnutrition.Methods A total of 148 elderly patients with liver cirrhosis in this hospital from January 2018 to January 2022 were included,and they were divided into the diabetic group(n=81)and the non-diabetic group(n=67)according to whether they were complicated with diabetes mellitus.The nutritional risk screening 2002 table(NRS-2002)was used to evaluate the nutritional risk of patients in the two groups,and the serological indicators were compared between the two groups.According to the NRS-2002 score,the diabetic group patients were divided into the well-nourished group and the malnourished group,and the influencing factors of malnutrition of elderly patients with liver cirrhosis and diabetes mellitus were discussed by multivariate logistic regression analysis.Results The percentage of NRS-2002 score≥3 in the diabetic group were significantly higher than that in the non-diabetic group(P<0.05).The levels of prealbumin(PA),albumin(ALB),total protein(TP),serum total cholesterol(CHOL)and hemoglobin(Hb)in the diabetic group were significantly lower than those in the non-diabetic group(P<0.05).Univariate analysis found that there were significant differences in disease duration,Child-Pugh grade,occurrence of complications of liver cirrhosis such as spontaneous peritonitis and ascites,living area,PA,ALB,TP,Hb,serum creatinine(Cr)between the well-nourished diabetic group and the malnourished group(P<0.05).Multivariate logistic regression analysis found that disease duration,Child-Pugh gade,ascites,spontaneous peritonitis,and ALB level were the influencing factors of malnutrition of elderly patients with liver cirrhosis and diabetes mellitus.Conclusion The incidence of malnutrition in elderly patients with cirrhosis and diabetes mellitus is high,and the disease duration,Child-Pugh grade,ascites,spontaneous peritonitis,and ALB level are the influencing factors for the occurrence of malnutrition.