住院老年病人营养状况与衰弱相关性研究  

Correlation between nutritional status and frailty in hospitalized elderly patients

作　　者：吕卫华[1] 王青[1] 赵清华[1] 吴薇[1] 翟雪靓 张少景 符琳琳[1] 

机构地区：[1]首都医科大学附属复兴医院干保科,北京100038

出　　处：《首都医科大学学报》2017年第3期377-380,共4页Journal of Capital Medical University

基　　金：北京市保健科研课题项目(2015-15)~~

摘　　要：目的探讨老年住院病人营养状况与衰弱之间的关系,为营养干预改善老年衰弱状况提供依据。方法选取年龄≥65岁的老年住院病人371例,根据Fried衰弱表型评估(Fried's Cardiovascular Health Study index,CHS index)得分将病人分为无衰弱组、衰弱前期组及衰弱组,采用营养风险筛查(Mini Nutritional Assessment-Short Form,MNA-SF)及生物化学测定方法评估病人营养状态,分析营养状况对衰弱的影响。结果从无衰弱组到衰弱组MNA-SF分值、血红蛋白、白蛋白浓度逐渐降低,差异有统计学意义(P<0.01),营养不良和营养不良风险的发生率逐渐升高,分别为12.4%、38.3%、58.0%,差异有统计学意义(P<0.01);Spearman相关分析显示,MNA-SF评分与衰弱呈负相关(r=-0.388,P<0.01),营养不良和营养不良风险与衰弱呈正相关(r=0.334,P<0.01);Logistic回归分析显示,校正年龄、性别、血红蛋白、白蛋白、共病、多重用药等因素后,营养不良增加衰弱的发生风险(OR=7.650,95%CI:3.58~16.3,P<0.01)。结论老年住院病人衰弱状态与营养状况相关,营养不良可能是衰弱的重要危险因素。Objective To explore the relationship between the nutritional status and frailty in hospitalized elderly patients and provide evidence for the nutritional intervention to improve the elderly frailty status. Methods A total of 371 elderly hospitalized patients aged 65 and over were selected and divided into non-frail, pre-frail and frail groups according to the Fried＇s Cardiovascular Health Study index （CHS index）. Mini Nutritional Assessment-Short Form （MNA-SF）and biochemical methods were used to assess the nutritional status of patients, and to analyze the effect of nutritional status on frailty. Results From non-frail group to frail group, the MNA-SF score, hemoglobin, albumin levels decreased gradually and the difference was statistically significant （P〈0.01）. The malnutrition and risk of malnutrition incidence increased gradually, which were 12.4%, 38.3% and 58.0%, respectively. The difference was statistically significant （P〈0.01）. Spearman correlation analysis showed that MNA-SF score was negatively correlated with frailty （r=-0.426, P〈0.01） and the malnutrition and risk malnutrition were positively correlated with frailty （r=0.405, P〈0.01）. Logistic regression analysis showed that the malnutrition increased the risk of frailty after adjusting for age, sex, hemoglobin, albumin, comorbidity, multiple drug use and other factors（OR=7.650, 95%CI：3.58=16.3, P〈0.01）. Conclusion There was a correlation between frail state and nutritional status in hospitalized elderly patients. The malnutrition is the important risk factor of the frail state.

关 键 词：老年 衰弱 营养不良 营养状况 衰弱表型评估 

分 类 号：R153.3[医药卫生—营养与食品卫生学]