老年血液肿瘤病人住院营养状态研究  

Clinical study of nutritional status in elderly patients with hematological tumour

作　　者：武悦[1] 张玲[1] 郭慧霞[1] 张晶晶[1] 陈以娟[1] 胡景[1] 王立茹[1] WU Yue;ZHANG Ling;GUO Hui-xia;ZHANG Jing-jing;CHEN Yi-juan;HU Jing;WANG Li-ru(Department of Hematology, Fuxing Hospital Affiliated to Capital Medical University, Beijing 100038, China)

机构地区：[1]首都医科大学附属复兴医院血液科,北京市100038

出　　处：《实用老年医学》2018年第4期374-378,共5页Practical Geriatrics

基　　金：北京市卫生系统高层次卫生技术人才培养计划(2013-3-097)

摘　　要：目的通过客观测量指标及营养筛查量表了解血液肿瘤病人营养不良的现状,探讨化疗对血液肿瘤病人营养状态的影响,以及营养不良/营养风险与感染发生率及住院天数的关系。方法选取我科131例年龄>60岁的血液肿瘤病人,采用营养风险筛查2002评估表(NRS2002)和微型营养评定精表法(MNA-SF)进行营养风险筛查,分析营养状态与年龄、化疗的关系以及营养状态对感染并发症和住院天数的影响。结果 (1)根据体质量指数(BMI)或白蛋白水平判断入院时营养不良44例(33.6%),根据NRS2002评分89例(67.9%)存在营养风险,根据MNA-SF评分营养不良18例(13.7%)。(2)随着年龄的增加,BMI逐渐下降(P<0.05),白蛋白、前白蛋白、总胆固醇也呈下降趋势,但差异无统计学意义。NRS2002及MNA-SF筛查结果提示营养风险或营养不良的病人平均年龄高于营养良好病人(P<0.05)。(3)病人化疗后白蛋白水平较化疗前明显降低(P<0.01)。NRS2002及MNA-SF筛查结果提示,化疗后营养风险或营养不良的病人均较化疗前增加(P<0.05或P<0.01)。(4)按照BMI或白蛋白标准,营养不良组住院天数长于营养良好组(P<0.01)。分别按照BMI或白蛋白、NRS2002评分标准,营养不良或营养风险病人中,感染发生率分别为68.2%、57.3%,均高于营养良好的病人(P<0.05)。结论老年血液肿瘤病人营养不良及营养风险发生率高,营养不良病人发生感染并发症风险高。Objective To investigate the nutritional status in elderly patients with hematological tumor,and to analyze the effect of chemotherapy on the nutritional status and the relationship between malnutrition or nutritional risk and clinical outcomes. Methods A total of 131 elderly patients with hematological tumor were enrolled in the study,anthropometric measures and biochemical tests were carried out in all patients. Nutritional risk screening 2002（ NRS2002） and Mini-Nutritional AssessmentShort Form（ MNA-SF） were used to assess the nutritional status. The incidence of malnutrition or nutritional risk,the effect of chemotherapy on the nutritional status,and the relationship between nutritional status and the clinical outcomes were analyzed. Results（ 1） Malnutrition were found in 44（ 33. 6%） patients by BMI or albumin,89（ 67. 9%） patients by NRS2002,and 18（ 13. 7%） patients by MNA-SF respetctively.（ 2） With the increase of age,BMI decreased（ P〈0. 05）. The age in the nutritional risk group or malnutrition group screened by NRS2002 and MNA-SF were significantly higher than that in well-nourished group（ P〈0. 05）.（ 3） After the chemotherapy,the level of albumin of all patients was significantly decreased compared with that before the chemotherapy（ P〈0. 01）. According to NRS2002 and MNA-SF,the proportion of malnutrition after the chemotherapy was significatly higher than that before the chemotherapy（ P〈0. 05 or P〈0. 01）.（ 4） According to BMI or albumin, the hospitalization stays in the patients with malnutrition was longer than that in well-nourished patients. and the incidence of infection in the patients with malnutrition or nutritional risk were 68. 2% and 57. 3%,respectively screened by BMI or albumin and NRS2002,which was higher than that in well-nourished patients（ P〈0. 05）. Conclusions Elderly patients with hematological tumor have a higher prevalence of malnutrition and a higher risk of malnutrition, and the incidence of infection complication in m

关 键 词：营养不良 营养风险 血液肿瘤 化疗 老年人 

分 类 号：R73[医药卫生—肿瘤] R591[医药卫生—临床医学]