老年急性白血病患者营养状况与医院感染的相关性研究  

The correlation study between nutritional status and nosocomial infeetion in elderly patients with acute leukemia

作　　者：陈晓文[1] 侯丽丽[2] 夏瑞祥[1] Chen Xiaoruen;Hou Lili;Xia Ruixiang(Department of Hematology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of Endocrinology,Department of Clinical Nutriology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院血液内科,合肥230022 [2]安徽医科大学第一附属医院内分泌科、临床营养科,合肥230022

出　　处：《中华老年医学杂志》2021年第7期895-898,共4页Chinese Journal of Geriatrics

基　　金：安徽高校自然科学研究项目(KJ2018ZD020)。

摘　　要：目的探讨老年急性白血病患者营养状况与发生医院感染的相关性.方法随机选取2015年6月至2017年12月在安徽医科大学第一附属医院血液内科住院治疗的202例老年急性白血病患者作为研究对象,通过患者主观整体评估(PG-SGA)法评估患者的营养状况,比较不同营养状态下患者的血常规及生化指标,分析临床特征与PG-SGA评分的相关性以及营养状况与医院感染的相关性,采用单因素分析及多因素Logistic回归分析老年急性白血病患者医院感染的相关因素.结果PG-SGA评分为0~8分患者血红蛋白、白蛋白分别为(97.02±2.86)g/L、(39.78±0.50)g/L,均高于评分≥9分患者(83.02±3.28)g/L、(37.71±0.71)g/L,前者C反应蛋白(CRP)(33.98±5.34)mg/L低于后者(58.82±8.36)mg/L(t=3.052、2.429、-2.504,P=0.003、0.016、0.015);不同年龄组、疾病阶段、疾病类型及有无胃肠道反应的患者PG-SGA评分差异均有统计学意义(t=-6.562、3.292、2.869、2.268,P=0.000、0.001、0.006、0.041);患者PG-SGA评分与医院感染的发生呈正相关(r=0.544,P=0.000);Logistic回归分析结果显示,PG-SGA评分(OR=2.11、95%CI:1.66~2.71、P=0.000)是老年急性白血病患者医院感染的独立危险因素,血清白蛋白(OR=0.86、95%CI:0.77~0.93、P=0.000)是老年急性白血病患者医院感染的保护因素.结论老年急性白血病患者的营养状况与医院感染的发生密切相关,存在营养不良的老年急性白血病患者应尽早给予足够的营养支持改善患者的营养状态及预后.Objective To investigate the correlation between nutritional status and nosocomial infection in elderly patients with acute leukemia.Methods A total of 202 elderly patients with acute leukemia hospitalized in the Department of Hematology of the First Affiliated Hospital of Anhui Medical University from June 2015 to December 2017 were randomly included as research objects.The nutritional status of patients was asssed by the Patient Generated Subjective Global Assessment(PG-SGA),and the blood routine and biochemical indexes were compared among patients with different nutritional conditions.The correlations bet ween clinical characteristics and PG SGA score and between nutritional status and nosocomial infection were analyzed.Univariate analysis and multivariate Logistic regression analysis were used to evaluate the related factors for the nosocomial infection.Results The hemoglobin and albumin were higher in patients with PG-SGA score of 0-8[(97.02±2.86)g/L.and(39.78±0.50)g/L.respectively ]than in patients with PG-SGA score≥9[(83.02±3.28)g/L and(37.71±0.71)g/L](P=0.003.0.016).And C-reactive protein(CRP)was lower in patients with PG-SGA score of 0-8[(33.98±5.34)mg/L]than in patients with PG SGA score≥9[(58.82±8.36)mg/L](P=0.015).There were significant differences in PG SGA scores among patients with different age.disease stage,disease type and gastrointestinal reaction(t=-6.562.3.292.2.869 and 2.268,P=0.000,0.001.0.006 and 0.041).The PG-SGA score was positively correlated with the incidence of nosocomial infection(r=0.544,P=0.000).Logistie regression analysis showed that PG-SGA score was an independent risk factor(OR=2.11.95%C1:1.66-2.71.P=0.000).And albumin was a protective factor(OR=0.86.95%C1:0.77-0.93.P=0.000)for the nosocomial infection in elderly patients with acute leukemia.Conclusions The nutritional status is closely related to the occurrence of nosocomial infection in elderly patients with acute leukemia.Elderly acute leukemia patients with malnutrition should be given adequate nutritional suppor

关 键 词：白血病 营养评价 感染 

分 类 号：R733.71[医药卫生—肿瘤]