老年肺炎患者营养状况探讨

Investigation of Nutritional State of the Senile Patients with Pneumonia

研究 30例老年人肺炎患者治疗前后身体测量、白蛋白 (Alb)、转铁蛋白 (TRF)、皮质醇 (Co)、三碘甲腺原氨酸 (T3)、四碘甲腺原氨酸 (T4 )、促甲状腺素 (TSH)、白细胞介素 - 1β(IL 1β)、胰岛素样生长因子 -Ⅱ (IGF Ⅱ )的变化 ,并以 19例健康青壮年人、2 0例健康老年人作为对照 ,探讨老年人肺炎患者的营养状况。结果肺炎组治疗前后比较身体测量指标均有升高趋势。老年组TRF、T3、T4 、TSH、Co、IGF Ⅱ较青年组为低。肺炎组TRF、T3、IGF Ⅱ较老年组降低 ,Co、IL 1β水平较老年组明显升高。肺炎组TRF、T3、IGF Ⅱ治疗后明显升高 ,Co、IL 1β水平明显降低。说明老年人肺炎患者存在不同程度的营养状况低下 ,这与激素合成和细胞因子分泌发生不同程度的紊乱有关。治疗后反映营养状况的身体测量指标以及体内激素。

Objective To investigate the changes of nutritional state of the senile patients with pneumonia before and after treatment. Methods Before and after treatment, the changes in the anthropometric criteria and in the levels of albumin (Alb), transferring (TRF), cortisol (Co), triiodothyronine (T 3), tetraiodothyronine (T 4), thyroid stimulating hormone (TSH), interleukin 1β(IL 1β) and insulin like growth factor Ⅱ(IGF Ⅱ) were detected in 30 senile patients of pneumonia, with 19 healthy young subjects and 20 healthy aged subjects as the control. Results It was found that the anthropometric criteria showed an increasing tendency both before and after treatment in the pneumonia group. The levels of TRF, T 3, T 4, TSH, Co and IGF Ⅱ were lower in the senile control group than those in the young control group. The levels of TRF, T 3 and IGF Ⅱwere lower in the pneumonia group than those in the senile control group, but the levels of Co and IL 1βwere higher in the pneumonia group than those in the senile control group. After treatment, the levels of TRF, T 3 and IGF Ⅱ increased in the pneumonia group, but levels of Co and IL 1βdecreased. Conclusion The senile patients of pneumonia are with malnutrition of different degrees, which is related with certain disorders of the synthesis of hormones and secretion of cytokines. The anthropometric criteria reflecting the nutritional state and the levels of hormones and cytokines can be all improved to a certain degree by the treatment.