脑卒中后患者营养不良与预后的相关性研究  

A study on the association between the nutritional status and the prognosis among post--stroke patients

作　　者：杨江胜[1] 王少石[2] 周晓宇[2] 刘春凤[1] 沈月平[3] 郝俊杰[1] 

机构地区：[1]苏州大学附属第二医院神经内科,215004 [2]上海交通大学附属第一人民医院分院神经科 [3]苏州大学医学部放射医学与公共卫生学院流行病与卫生统计教研室

出　　处：《神经疾病与精神卫生》2009年第1期37-40,共4页Journal of Neuroscience and Mental Health

基　　金：致谢：感谢上海市虹口区广中社区医院王爱平、欧阳社区医院姜虹、提篮社区医院陈宝麟、曲阳社区医院陆丽宁、新港社区医院姚保富、嘉兴社区医院吴巍、江湾社区医院李建滨、凉城社区医院黄岳岳、乍浦社区医院李荣幸对本课题的大力协助.

摘　　要：目的调查脑卒中后患者营养不良的发生率；探讨卒中后患者营养不良与神经功能缺损程度、残障程度、日常生活能力、感染和并发症发生率之间的关系。方法采用横断面研究，研究对象为438例在社区医院住院的卒中后患者，记录其人口学特征、营养学评定指标、神经功能缺损评分（NIH—SS）、mRS评分、Barthel指数、感染和并发症的发生情况。结果脑卒中后患者营养不良的发生率达52．7％；卒中后营养不良的患者中中重度神经功能缺损（NIHSS〉4分）的占77．1％，重度残障（mRS评分4～5分）的占70．1％，日常生活重度依赖及完全依赖（Barthel指数0～45分）的占69．7％，感染发生率为34．6％。并发症发生率为55．4％；而正常营养状态患者，相应的比例分别为24．2％、21．3％、19．8％、11．6％和18．8％。结论卒中后患者营养不良的发生率高，营养不良与神经功能缺损程度、残障程度，日常生活能力，感染和并发症发生率具有相关性（P〈0．0001），营养不良的患者神经功能缺损程度、残障程度严重，日常生活能力低下，感染和并发症发生率高，关注卒中后患者营养不良对改善卒中预后有积极作用。Objective To investigate the incidence of malnutrition among post stroke patients, and to discuss the associations between nutritional status and neurological deficit, disability, activities of daily living, the incidences of infection and complication. Methods A cross sectional study was carried out among 438 post--stroke patients who were admitted at community hospitals, linformation was gathered about demographic characteristics, nutrition assessment indices, NIHSS score, modified Rankins score, Barthel index, the incidences of infection and complication. Results The incidence rate of malnu trition reached 52.7% among post--stroke patients at community hospitals. The rate of malnutritional post stroke patients with moderate and severe neurological deficits （NIHSS score 〉4） accounted for 77. 1%, severe disability （mRS score 4-5） accounted for 70. 1%, severe and complete dependence on activities of daily living （Barthel index score 0-45） accounted for 69.7%, and the incidences of infection and complication were 34.6 % and 55.4%, respectively. Whereas the corresponding incidences were 24. 2%, 21.3%, 19.8%, 11.6% and 18. 8% among eutrophic patients, respectively. Conclusions There is high incidence of malnutrition among post-- stroke patients. Malnutrition of post-- stroke patient is associated with neurological deficit, activity of daily living, disability, the incidences of infection and complication （P〈0. 0001 ）. Malnourished post--stroke patients are always accompanied with serious neurological deficit, serious disability, poor activities of daily living, high incidences of infection and complication. Pay- ing more attention to nutritional status of post--stroke patients will improve the prognosis of post-- stroke patients.

关 键 词：脑卒中 营养不良 预后 

分 类 号：R743.305[医药卫生—神经病学与精神病学] R743.33[医药卫生—临床医学]