新型冠状病毒肺炎患者不同营养风险临床资料的比较及营养与临床类型的相关性研究  

Comparison of clinical data of COVID-19 patients with different nutritional risk and the correlation between nutrion and clinical classifications

作　　者：黄鸿[1] 幸奠霞[1] 刘燕[1] 邓静 吴小婷 彭诗敏 王霞 覃燕华 张一 张莉[1] 王亚玲 Huang Hong;Xing Dianxia;Liu Yan;Deng Jing;Wu Xiaoting;Peng Shimin;Wang Xia;Qin Yanhua;Zhang Yi;Zhang Li;Wang Yaling(Geriatric Department,Chongqing Three Gorges Central Hospital)

机构地区：[1]重庆三峡中心医院老年科,重庆404100

出　　处：《重庆医科大学学报》2020年第7期937-941,共5页Journal of Chongqing Medical University

摘　　要：目的:应用营养风险筛查(nutrition risk screening 2002,NRS2002)量表对新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者进行营养筛查,研究不同营养风险的患者临床资料差异及营养是否与该病的临床类型相关。方法:选择2020年1月24日至2月29日重庆三峡中心医院收治的241例COVID-19患者为研究对象,按国家卫健委制定的《新型冠状病毒感染的肺炎诊疗方案(试行第六版)》确定患者的临床类型,据NRS2002评分值将所有患者分为有营养风险组(NRS2002评分≥3分)与无营养风险组(NRS2002评分<3分),比较2组间年龄、性别、基础疾病、实验室指标及临床分型差异,对营养评分与临床类型进行相关分析,应用多元有序logistic回归分析影响患者临床类型的危险因素。结果:有营养风险组患者年龄更大(P=0.000),合并慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)(P=0.023)及糖尿病者(P=0.000)更多,C反应蛋白(C-reactive protein,CRP)更高(P=0.000),而氧分压(P=0.038)、淋巴细胞计数(P=0.000)及白蛋白(P=0.000)较无营养风险者更低;NRS2002评分与临床类型的相关分析提示二者呈正相关(r=0.635),NRS2002评分是患者临床类型的独立危险因素(OR=6.841,P=0.000)。结论:营养风险是COVID-19患者临床类型的独立预测因素,应用NRS2002对COVID-19患者筛查的结果可用于快速指导患者院内分流及营养支持治疗。Objective:To investigate the differences in clinical data of coronavirus disease 2019(COVID-19)patients with different nutritional risks and the correlation between nutrition and clinical classifications through nutritional risk screening 2002(NRS2002).Methods:A total of 241 patients admitted to Chongqing Three Gorges Central Hospital from January 24th,2020 to February 29th,2020 were included in this research.Clinical classifications were defined according to the sixth edition of the"diagnosis and treatment plan of novel coronavirus pneumonia"promulgate by the National Health Commission of China,and all patients were di vided into the nutritional risk group(NRS2002 score≥3)and the non-nutritional risk group(NRS2002 score<3).The difference of age,gender,basic diseases,laboratory indexes and clinical classifications were compared in these groups.The correlation between the NRS2002 score and clinical classifications were analyzed.The risk factors of clinical classifications were analyzed by multiple ordinal logistic regression.Results:The patients in the nutritional risk group were older(P=0.000),and there were more patients with COPD(P=0.023)and diabetes(P=0.000)in this group.However,the oxygen partial pressure(P=0.038),lymphocyte counts(P=0.000)and serum albumin(P=0.000)were lower than those of the non-nutritional risk group.The correlation analysis between NRS2002 scores and clinical classifications suggested a positive correlation between them(r=0.635).NRS2002 score was an independent risk factor of clinical classifications(OR=6.841,P=0.000).Conclusion:Nutrional risk score is an independent predictor of the clinical classifications of COVID-19 patients.NRS2002 can be used in the evaluation and screening of COVID-19 patients,and it can be used to guide in-hospital triage and nutritional therapy simply and rapidly.

关 键 词：新型冠状病毒肺炎 营养风险筛查 营养风险 临床资料 临床类型 

分 类 号：R512.99[医药卫生—内科学]