营养代谢与急性脑梗死患者病情及生存状况的关系  

Relationship between nutritional and metabolic status and living conditions of acute illness and cerebral infarction

作　　者：成帅[1] 丁长霞[1] 

机构地区：[1]黄骅市人民医院神经内科,河北黄骅061100

出　　处：《西部医学》2016年第12期1690-1692,1696,共4页Medical Journal of West China

基　　金：河北省卫生厅科研课题(2010472988412)

摘　　要：目的探讨营养代谢状况与急性脑梗死患者病情及生存状况的关系。方法选取2013年1月～2015年1月我院收治的80例急性脑梗死患者为研究对象。记录患者入院第1、7、14天时的各项营养相关物理指标和实验室指标，并分析急性脑梗死患者结局与血生化指标检测值的关系。结果急性脑梗死患者入院第1、7、14d时的体质量、三头肌皮褶厚度、体质指数（BMI）、上臂围、上臂肌围的检测值均无显著变化，差异无统计学意义（P〉0．05）。息性脑梗死患者入院后前白蛋白在第7d显著低于第1d，但第14d回升；超敏C-反应蛋白（hs—CRP）在第7d和第14d均高于第1d；补体C3第7d和第14d均低于第1d，且第14d低于第7d；皮质醇在第7d和第14d均高于第1d，差异均有统计学意义（均P〈0．05）。改良Rankin分值≤2分的患者各项血生化指标检测值变化低于改良Rankin分值〉2分的患者，差异均有统计学意义（均P〈0．05）。说明急性脑梗死营养代谢紊乱较严重的患者结局不良。Rankin分值≤2分的患者半年内生存率为87．5％（42／48例），改良Rankin分值〉2分的患者半年内生存率为75．0％（24／32例），差异均有统计学意义（均P〈0．05）。结论部分急性脑梗死患者存在严重的营养代谢紊乱，营养代谢紊乱程度越严重其入院时病情越严重，生存率越低。Objective To explore the relationship between nutrition and metabolic status and living conditions of acute cerebral disease patients. Methods 80 patients with acute cerebral infarction during January 2015 in our hospital were involved in the study. The nutrition-related physical indicators and laboratory parameters at day 1, 7 days and 14 days were recorded. The relationship between acute outcomes and blood biochemical parameters value of cerebral infarction were analyzed. Results The body weight triceps skin/old thickness, body mass index （BMI）, arm circumference and arm muscle eircumference of the patients at day 7 and 14 days after hospital admission were not different that before hospital admission （P〉0.05）. The albumin decreased at day 7 of admission and recovered at day 14 of admission. Hy- persensitivity C-reactive protein （CRP） at day 7 and day 14 of admission were higher than that at day 1. Complement C3 at day 7 and day 14 day of admission were lower than that at day 1 of admission. Cortisol at 7 and 14 day of admission were higher than that at day 1 of admission. These differences were statistically meaningful（P〈0.05）. The blood biochemical parameters of patients with modified Rankin score 42 were lower than that with e modified Rankin score〉 2 （P〈0.05）, which shown that the nutritional and metabolic disorders in acute cerebral infarction patients had more severe adverse outcomes. The survival rate within six months of patients with Rankin score 42 and e〉 2 was 87. 5% （42/48） and 75.0%（24/32） （P〈0.05）. Conclusion The acute cerebral infarction exists a serious nutritional and metabolic disorders. The more serious nutritional and metabolic disorder of the patients, the lower the survival rate.

关 键 词：急性脑梗死 营养代谢状况 病情 生存状况 

分 类 号：R743.32[医药卫生—神经病学与精神病学] R151.2[医药卫生—临床医学]