影响卒中后患者营养不良相关因素的研究  

The risk factors for malnutrition in post-stroke patients

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

机构地区：[1]上海交通大学附属上海市第一人民医院分院神经科,200081 [2]苏州大学附属第二医院神经内科 [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：《中华内科杂志》2009年第12期1016-1018,共3页Chinese Journal of Internal Medicine

摘　　要：目的调查社区医院住院的卒中后患者营养不良的检出率以探讨影响恢复期卒中患者营养不良的相关因素。方法采用横断面研究，以438例社区医院住院的卒中后患者为研究对象，记录营养学评定指标及可能导致营养不良的相关因素。结果438例卒中后患者营养不良的检出率达52．7％；多因素logistic回归分析显示：卒中次数越多、美国国立卫生研究院卒中评分及Rankin残障量表评分分值越高，检出营养不良的风险越大（趋势检验P〈0．0001），营养不良的风险还与卒中后抑郁、家庭照料差、未进行早期康复及大量饮酒史相关。结论社区医院卒中后患者营养不良检出率高、影响因素多，关注卒中后患者营养状况的可控因素有利于卒中预后。Objective To investigate the detection rate of malnutrition among post-stroke patients in community hospitals and unravel the relevant factors that precipitate malnutrition after stroke. Methods Based on 438 post-stroke patients who were admitted in community hospitals, we examined the demographic characteristics, the nutritional indices and the possible malnutrition related factors through a cross-sectional study. Results The detection rate of malnutrition among post-stroke patients was 52. 7%. Group comparison tbrough multivariate logistic regression analysis sbowed that there was a higher malnutrition detection rate in the post-stroke patients with multiple stroke attacks （ three stroke attackes and above, OR = 11.00,95% CI 1.14-106. 34）, higher NIHSS scores （ group with NIHSS ≥ 15, OR = 7.09, 95% CI 2.90- 17.36）, higher modified Rankin scales （ group mRS 4-5, OR = 15.77,95% CI 6. 61-37.59） （ trend test P 〈0. 0001 ） . The risk of malnutrition was also correlated with the post-stroke depression, poorer family care, no early-stage rehabilitation, history of malignant tumors and severe alcoholism. Conclusions There is a high detection rate of malnutrition among post-stroke patients in community hospitals. There are many factors related to malnutrition among post-stroke patients in the community. More attention to controllable influencing factors would improve the prognosis of post-stroke patients.

关 键 词：卒中 营养不良 预后 药物 临床 

分 类 号：R686[医药卫生—骨科学]