克罗恩病病人疲乏相关因素研究  

Factors related to fatigue in patients with Crohn's disease

作　　者：孙琳 曾星 徐金中 沈如婷 叶向红 SUN Lin;ZENG Xing;XU Jin-zhong;SHEN Ru-ting;YE Xiang-hong(Nursing Department,Jinling Hospital,Nanjing 210000,Jiangsu,China;Nursing School of Guizhou University of TCM,Guiyang,550025,Guizhou,China;Department of General Surgery,Jinling Hospital,Nanjing 210000,Jiangsu,China)

机构地区：[1]东部战区总医院护理部,江苏南京210000 [2]贵州中医药大学护理学院,贵州贵阳550025 [3]东部战区总医院普通外科,江苏南京210000

出　　处：《肠外与肠内营养》2020年第3期176-180,共5页Parenteral & Enteral Nutrition

摘　　要：目的:分析克罗恩病(CD)病人营养不良、C反应蛋白(CRP)、简化CDAI及人体体成分与疲乏水平的相关性。方法:使用自行设计的一般资料问卷、身体质量指数(BMI)、简化CDAI、多维疲乏问卷(MFI-20)及生物电阻抗,采用便利抽样法,对东部战区总医院的138例CD住院病人的营养不良、疾病活动度、疲乏水平、人体体成分进行调查评估和测量,同时收集病人同期的CRP数据纳入分析。结果:CD病人MFI-20总分为(60.93±13.42)分,条目平均分3.047分;体力疲乏、脑力疲乏、动力下降及活动减少四个维度得分分别为(30.22±7.88)分、(10.57±3.31)分、(9.17±2.57)分、(10.98±3.17)分;四个维度每条目平均分分别为3.022分、2.643分、3.057分、3.660分。138例CD病人中,BMI:10.3~29.0 kg/m2,平均(18.5±3.6)kg/m2,简化CDAI中位数及四分位差为3(2.3)分,CRP中位数及四分位差为6.3(30.1)mg/L,营养不良发生率52.9%。相关性分析显示简化CDAI、CRP、营养不良及人体成分与疲乏水平具有相关性,人体成分中的细胞内液、蛋白质、骨骼肌量及人体细胞量与疲乏水平存在负相关(P<0.01),内脏脂肪面积与疲乏水平成正相关(P<0.05)。结论:CD病人普遍存在疲乏,与疾病活动度、炎症状态、营养不良及人体成分密切相关。应积极评估病人疲乏水平,控制炎症水平,诱导疾病缓解,并采用营养及运动干预等方式改善病人的人体体成分,以改善病人的疲乏状态,提高病人生活质量。Objective:To estimate the correlations between malnutrition,serum C-reactive protein(CRP)level,simplified Crohn’s disease activity index(CDAI),body composition and fatigue in patients with Crohn's disease(CD).Methods:A total of 138 CD patients who were hospitalized in the General Hospital of Eastern Theater Command were enrolled in this study.The patients’nutritional status,body mass index(BMI),disease activities and fatigue levels were evaluated using the self-designed general data questionnaire,body composition analyzer,simplified Crohn’s Disease Activity Index and multidimen-sional fatigue inventory(MFI-20),respectively.The levels of serum CRP in the patients were measured.Results:The MFI-20 score in CD patients was(60.93±13.42),and the score of each item was averagely 3.047.The scores of physical fatigue,mental fatigue,decreased motivation and activity reduction were(30.22±7.88),(10.57±3.31),(9.17±2.57),(10.98±3.17),respectively.The average score of each item in the four key parameters were 3.022,2.643,3.057,3.66.The BMI of CD patients was 10.3~29.0(18.5±3.6)kg/m2,the median and quartile difference of CRP was 6.3(30.1)mg/L,the median and quartile difference of simplified CDAI was 3(2.3),and the incidence of malnutrition was 52.9%.Correlation analysis showed that the malnutrition,simplified CDAI,serum CRP levels,and body composition were associated with the fatigue levels in CD patients.Intracellular fluid,protein content,skeletal muscle mass and quantity of cells in the patients were negatively related to the fatigue(P<0.01),and the visceral fat showed positive association with the fatigue(P<0.05).Conclusion:CD patients show higher fatigue levels,which are closely associated with the malnutrition,serum CRP,simplified CDAI and body composition.Assessment of fatigue in CD patients should be used during the clinical treatment and nursing.The fatigue state and life quality of the patients might be improved by reducing inflammatory levels,enhancing the nutritional status and exercise intervention.

关 键 词：克罗恩病 营养不良 简化CDAI C反应蛋白 人体体成分 疲乏 

分 类 号：R574.62[医药卫生—消化系统]