耐多药结核病患者营养风险筛查及影响因素分析  

Nutritional risk status and influencing factors in MDR-TB patients

作　　者：韦柳迎[1] 黄连飘[1] 郑元甲 卢巧玲 董文逸[1] 吴幸幸 韦征 裴洁[1] 黄献珍[1] 黄爱春[1] 谢周华[1] WEI Liu-ying;HUANG Lian-piao;ZHENG Yuan-jia;LU Qiao-ling;DONG Wen-yi;WU Xing-xing;WEI Zheng;PEI Jie;HUANG Xian-zhen;HUANG Ai-chun;XIE Zhou-hua(Guangxi AIDS Clinical Treatment Center,The Fourth People's Hospital of Nanning,Nanning,Guangxi 530023,China)

机构地区：[1]广西艾滋病临床治疗中心南宁市第四人民医院,广西南宁530023

出　　处：《中国热带医学》2022年第5期450-453,457,共5页China Tropical Medicine

基　　金：南宁市科学研究与技术开发计划项目(No.20213025-3)。

摘　　要：目的 探讨MDR-TB患者的营养风险状况及影响因素,为营养干预提供参考。方法 应用营养风险筛查2002(nutritional risk screening 2002,NRS2002)对241例MDR-TB患者进行营养风险筛查,评分<3分的患者纳入无营养风险组,评分≥3分的纳入营养风险组,先采用单因素分析初步筛选可能的影响因素,再采用Logistic多因素回归分析进行筛选。结果 按照NRS2002评分标准,MDR-TB患者存在营养风险发生率为57.26%(138/241);单因素分析显示家庭月收入、职业、婚姻状况、居住地、初治/复治、体重下降>5%、肺叶受累情况、年龄、血红蛋白、白蛋白、BMI等11项因素有统计学意义(P<0.05),再进行多因素Logistic回归分析,最终进入回归模型的因素为初治/复治、体重下降>5%、白蛋白,调整的OR值及OR 95%CI分别为4.184(2.163~8.093)、1.524(1.093~2.126)、1.164(1.105~1.227)。结论 营养师对复治MDR-TB患者、体重下降>5%、白蛋白降低的MDR-TB患者给予重点关注营养状况。采用适用的营养干预措施,改善患者的营养不良,提高MDR-TB的治疗效果。ObjectiveTo investigate the nutritional risk status and influencing factors of MDR-TB patients, in order toprovide reference for nutritional intervention.MethodsNRS2002 was used to screen the nutritional risk of 241 MDR-TBpatients. Patients with scores <3 were included in the non-nutritional risk group, and those with scores ≥3 were included in thenutritional risk group. Univariate analysis was used to initially screen possible influencing factors, and then Logisticmultivariate regression analysis was used to screen.ResultsThe incidence of nutritional risk in MDR-TB patients was57.26%(138/241) according to the NRS2002 scoring standard. Univariate analysis showed that 11 factors, including familymonthly income, occupation, marital status, place of residence, initial/recurrent treatment, weight loss >5% months, pulmonaryinvolvement, age, hemoglobin, albumin and BMI, were statistically significant(P<0.05). Single factors with statisticalsignificance were included in multivariate Logistic regression analysis. The factors that finally entered the regression modelwere initial treatment/re-treatment, weight loss>5% and albumin;The adjusted OR and OR95%CI were 4.184(2.163-8.093),1.524(1.093-2.126) and 1.164(1.105-1.227), respectively.ConclusionDietitians should pay more attention to thenutritional status of mDR-TB patients, mDR-TB patients with weight loss of >5% and albumin reduction. Appropriatenutritional interventions were adopted to improve the malnutrition of patients and improve the therapeutic effect of MDR-TB.

关 键 词：耐多药结核 住院患者 营养风险筛查 影响因素 调查分析 

分 类 号：R52[医药卫生—内科学]